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Individual

MS. KATHY ILENE ALDEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1865 UPPER CHELSEA RD, COLUMBUS, OH 43212-1939
(614) 477-5720
Mailing address
1865 UPPER CHELSEA RD, COLUMBUS, OH 43212-1939
(614) 477-5720

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
2624664
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2530452
ODMRDD CONTRACT NUMBER
OH
05
2624664
OH
Enumeration date
05/01/2007
Last updated
09/13/2012
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