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: |