Individual
KELLY WILCOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1176 DEVONWOOD RD, MANSFIELD, OH 44907-2421
(419) 564-0043
Mailing address
1176 DEVONWOOD RD, MANSFIELD, OH 44907-2421
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP-3865
OH
Other
Enumeration date
01/14/2015
Last updated
01/14/2015
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