Individual
MRS. DEIDRE ANN KONDIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
4000 OUT LOOK DR, HURRICANE, WV 25526-9467
(330) 338-8862
Mailing address
4000 OUT LOOK DR, HURRICANE, WV 25526-9467
(330) 338-8862
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-1555
WV
235Z00000X
Speech-Language Pathologist
SP6401
OH
Other
Enumeration date
03/27/2007
Last updated
11/10/2014
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