Individual
ANTONIQUE Y INGRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2150 W CENTRAL AVE, TOLEDO, OH 43606-3834
(419) 291-7919
(419) 479-3273
Mailing address
333 N SUMMIT ST FL 7, TOLEDO, OH 43604-1531
(419) 291-7919
(419) 479-3273
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
C.1700751
OH
Other
Enumeration date
09/16/2019
Last updated
01/14/2021
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