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General NPI Number Information
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NPI Number | 1952974560
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Entity Type | Individual
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Provider Name | TESHAUNA LYNN ISAAC
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Gender | Female
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Dates
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Enumeration Date | 07/21/2021
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 2475 COLLINGWOOD BLVD STE 110
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City | TOLEDO
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State | OH
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Zip | 43620-1180
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Country | US
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Telephone | 419-944-5469
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Fax |
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Provider Business Mailing Address
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Address Line | 1125 N HOLLAND SYLVANIA RD APT L8
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City | TOLEDO
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State | OH
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Zip | 43615-4469
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Country | US
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Telephone | 419-944-5469
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | E.2606045
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License Number State | OH
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