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Individual

MR. JONATHAN SKIDMORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSW, LISW-S, CTP

Contact information

Practice address
6715 DORR ST., TOLEDO, OH 43615
(419) 868-1178
(419) 868-1989
Mailing address
PO BOX 400, HOLLAND, OH 43528
(419) 841-7701
(419) 841-1691

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I.1502371
OH
171M00000X
Case Manager/Care Coordinator

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0165312
OH
Enumeration date
11/30/2015
Last updated
09/03/2019
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