Individual
KRISTEN KONECNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
926 E WAYNE ST, SOUTH BEND, IN 46617-3000
(574) 233-8812
Mailing address
926 E WAYNE ST, SOUTH BEND, IN 46617-3000
(574) 233-8812
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32002678A
IN
Other
Enumeration date
07/07/2014
Last updated
07/07/2014
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