| NPI Details | |
|---|---|
| NPI | 1700076817 |
| Gender | Female |
| Enumeration Date | 07/26/2007 |
| Last Updated | 07/16/2013 |
| Entity Type | Individual |
| Active | Over 9 years ago |
| Practice Location | |
|---|---|
| 5743 FOREST ELM LN APT B COLUMBUS OH, 43229-3753, US |
|
| Phone | (614) 582-9374 |
| Fax | |
| Business Location | |
|---|---|
| 5743 FOREST ELM LN APT B COLUMBUS OH, 43229-3753, US |
|
| Phone | (614) 582-9374 |
| Fax | |
| Toxanomy | |
|---|---|
| Taxonomy Code | 1041C0700X |
| License State | Ohio |
| License Number | 7839 |
| Remove 1700076817 NPI Number | |
According to our database, Kellie Lyn Rae LISW NPI is 1700076817, taxonomy code is 1041C0700X and license number is 7839, license state is located at Ohio. Kellie Lyn Rae LISW physically located at 5743 Forest Elm Ln Apt B, Columbus OH, 43229-3753. NPI Number Kellie Lyn Rae LISW has the Individual type.
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1700076817 NPI number is provided on an as is basis without warranty of any kind. 1700076817 is maintained by the National Plan & Provider Enumeration System. The contents of Kellie Lyn Rae LISW are for informational purposes only.
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