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Individual

KENNETH JOHN KATRICAK I

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
1131 E BROAD ST, ELYRIA, OH 44035-6305
(216) 270-7464
(440) 387-4706
Mailing address
1131 E BROAD ST, ELYRIA, OH 44035-6305
(216) 270-7464
(440) 387-4706

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C1801465
OH
163WG0000X
General Practice Registered Nurse
RN212255
OH

Other

Enumeration date
01/22/2021
Last updated
01/22/2021
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