Provider Demographics
NPI:1679370332
Name:ELSON, KATHRYN M
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:M
Last Name:ELSON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 PADDOCK COURT ST B
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-1317
Mailing Address - Country:US
Mailing Address - Phone:740-363-1619
Mailing Address - Fax:
Practice Address - Street 1:241 PADDOCK CT STE B
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-1317
Practice Address - Country:US
Practice Address - Phone:740-363-1619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPS.005260175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist