Individual
OLGA KONDRATYUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1579 S LAKE CREST WAY, EAGLE, ID 83616-7141
(208) 250-6583
(208) 639-6298
Mailing address
1579 S LAKE CREST WAY, EAGLE, ID 83616-7141
(208) 250-6583
(208) 639-6298
Taxonomy
Speciality
Code
Description
License number
State
171R00000X
Interpreter
—
—
172A00000X
Driver
—
—
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
376J00000X
Homemaker
Primary
—
—
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
05/24/2011
Last updated
05/24/2011
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