Individual
YAROSLAV KONDOUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
20600 CHAGRIN BLVD STE 620, SHAKER HEIGHTS, OH 44122-5340
(216) 751-4762
Mailing address
3413 FRIAR DR, PARMA, OH 44134-5520
(440) 864-0986
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
RN.378568
OH
Other
Enumeration date
08/14/2017
Last updated
08/14/2017
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