Provider Demographics
NPI:1215101399
Name:CHILD & ADULT REHAB SERV INC
Entity type:Organization
Organization Name:CHILD & ADULT REHAB SERV INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LOIS
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:KONDAS
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC SP
Authorized Official - Phone:301-645-6540
Mailing Address - Street 1:85 HIGH STREET
Mailing Address - Street 2:SUITE 7
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-2150
Mailing Address - Country:US
Mailing Address - Phone:301-645-6540
Mailing Address - Fax:301-934-8302
Practice Address - Street 1:85 HIGH STREET
Practice Address - Street 2:SUITE 7
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-2150
Practice Address - Country:US
Practice Address - Phone:301-645-6540
Practice Address - Fax:301-934-8302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-18
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01538235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty