Individual
TRACE ELLING-COCKERELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1319 FLORENCEDALE AVE, YOUNGSTOWN, OH 44505-2712
(330) 743-4673
Mailing address
1319 FLORENCEDALE AVE, YOUNGSTOWN, OH 44505-2712
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
APS.006475
OH
Other
Enumeration date
06/04/2025
Last updated
06/04/2025
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