Most Relevant Information
Provider Data
NPI Number: | 1003293267 |
Provider Name: | KEGAN D BERADUCE MSW LISW |
Entity Type: | Individual |
Taxonomy Code: | 104100000X |
Specialty: | Social Worker |
License Number: | S1450434 |
Most Important Dates
Enumeration Date: | 04/27/2015 |
Last Updated: | 10/04/2021 |
Provider Practice Location
3600 OLENTANGY RIVER RD # D-102
COLUMBUS
OH
432143437
Practice Location Phone/Fax
Phone: | 6143021478 |
Fax: |
Provider Mailing Location
3600 OLENTANGY RIVER RD # D-102
COLUMBUS
OH
432143437
Provider Mailing Phone/Fax
Phone: | 6143021478 |
Fax: |