Provider Demographics
NPI:1154996015
Name:KAHKONEN, EMILY LEFFEL (LMT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:LEFFEL
Last Name:KAHKONEN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:826 STRAWDERMAN RD
Mailing Address - Street 2:
Mailing Address - City:MATHIAS
Mailing Address - State:WV
Mailing Address - Zip Code:26812-8262
Mailing Address - Country:US
Mailing Address - Phone:301-437-8663
Mailing Address - Fax:
Practice Address - Street 1:WARDENSVILLE COMMUNITY CENTER
Practice Address - Street 2:345 E MAIN STREET SUITE D
Practice Address - City:WARDENSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26851-2681
Practice Address - Country:US
Practice Address - Phone:301-437-8663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-24
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2016-3446225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist