Healthcare Provider Details

I. General information

NPI: 1740076223
Provider Name (Legal Business Name): TONIA SHENELLA DUPREE LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2025
Last Update Date: 07/18/2026
Certification Date: 07/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5577 AIRPORT HWY STE 200
TOLEDO OH
43615-7364
US

IV. Provider business mailing address

27731 LAKE SHORE BLVD
EUCLID OH
44132-1329
US

V. Phone/Fax

Practice location:
  • Phone: 419-720-0442
  • Fax:
Mailing address:
  • Phone: 216-334-6882
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS-2614314
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: