Healthcare Provider Details

I. General information

NPI: 1134031057
Provider Name (Legal Business Name): MINYON OVERTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 S BYRNE RD
TOLEDO OH
43609-1005
US

IV. Provider business mailing address

709 S BYRNE RD
TOLEDO OH
43609-1005
US

V. Phone/Fax

Practice location:
  • Phone: 567-463-2717
  • Fax: 419-720-5354
Mailing address:
  • Phone: 567-463-2717
  • Fax: 419-720-5354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: