Individual
JORDAN KAVANAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5151 MONROE ST STE 204, TOLEDO, OH 43623-3467
(419) 865-5690
Mailing address
1205 WOODSIDE BLVD STE 204, MIDDLETOWN, OH 45044-5652
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/21/2022
Last updated
04/21/2022
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