Individual
MRS. TRACY LYNETTE SHELLOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2255 JERMAIN DR, COLUMBUS, OH 43211-2362
(614) 378-3189
Mailing address
2255 JERMAIN DR, COLUMBUS, OH 43211-2362
(614) 378-3189
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1245678980
OH
Other
Enumeration date
07/02/2025
Last updated
07/02/2025
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