Individual
COURTNEY J SRIHAVONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1832 ADAMS ST, TOLEDO, OH 43604-4428
(419) 720-9247
Mailing address
3611 PRAIRIE AVE, TOLEDO, OH 43614-5141
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/16/2020
Last updated
01/16/2020
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