Individual
GRACE NICHOLE NICATA PORTENTOSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1205 KING RD, TOLEDO, OH 43617-2013
(419) 867-5666
Mailing address
1205 KING RD, TOLEDO, OH 43617-2013
(419) 867-5666
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
COND.20222021-SP
OH
Other
Enumeration date
09/19/2022
Last updated
09/19/2022
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