Basic Information
| Provider Information | |||||||||
| NPI: | 1356596035 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KONDAS | ||||||||
| FirstName: | MICHELE | ||||||||
| MiddleName: | LEIGH | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | COTA/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 885 MACBETH DR | ||||||||
| Address2: | |||||||||
| City: | MONROEVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 151463332 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4128567071 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 885 MACBETH DR | ||||||||
| Address2: | |||||||||
| City: | MONROEVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 151463332 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4128567071 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/23/2008 | ||||||||
| LastUpdateDate: | 11/23/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Z00000X | OP005807 | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
No ID Information.