| Doctor Name: | KELLI N MANN |
| NPI Number: | 1013269315 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PCC |
| License Number: | C 1100525 |
| Business Practice Address: | 624 Market Ave. N. Canton, OH - 447021017 |
| Business Phone Number: | 3304934553 |
| Business Fax Number: | 3304933761 |
| Mailing Address: | 624 Market Ave, N, CANTON |
| State: | OH |
| Postal Code: | 447021017 |
| Phone Number: | 3304934553 |
| Fax Number: | 3304933761 |
| NPI Enumeration Date: | 10/10/2012 |
| NPI Last Update Date: | 04/14/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | C 1100525 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |