Individual
SVITLANA KONDOUCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3413 FRIAR DR, PARMA, OH 44134-5520
(440) 864-0984
Mailing address
3413 FRIAR DR, PARMA, OH 44134-5520
(440) 864-0984
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
347C00000X
Private Vehicle
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1827312
—
OH
Enumeration date
11/23/2020
Last updated
11/23/2020
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