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Individual

ELIJAH MENSAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1033 LARCHWOOD RD, MANSFIELD, OH 44907-2424
(419) 747-4122
Mailing address
1033 LARCHWOOD RD, MANSFIELD, OH 44907-2424
(419) 747-4122

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
171M00000X
Case Manager/Care Coordinator
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2910854
OH
Enumeration date
05/11/2021
Last updated
06/16/2023
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