Individual
MRS. JORDAN NICOLE THEPSOURINTHONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
2121 HUGHES DR STE 640, TOLEDO, OH 43606-5131
(419) 291-3960
Mailing address
516 BRODYWOOD DR, TOLEDO, OH 43615-4584
(419) 215-7762
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I.2304664
OH
Other
Enumeration date
08/09/2023
Last updated
08/09/2023
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