Individual
ANTRIONNA CAVANAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1800 N MCCORD RD APT 45, TOLEDO, OH 43615-3091
(419) 764-7668
Mailing address
PO BOX 350415, TOLEDO, OH 43635-0415
(419) 764-7668
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
Primary
—
OH
Other
Enumeration date
11/11/2022
Last updated
11/11/2022
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