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Individual

LAVENIA ANTIONETTE DUPREE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5096 DONOVAN DR, GARFIELD HEIGHTS, OH 44125-2052
(216) 773-0149
Mailing address
13111 SHAKER SQ STE 204, CLEVELAND, OH 44120-2345
(216) 583-6526

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
1830406
OH

Other

Enumeration date
11/17/2020
Last updated
11/17/2020
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