Provider Demographics
NPI:1306489133
Name:KESNER, MONICA
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:KESNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 MILLER LN
Mailing Address - Street 2:
Mailing Address - City:WAYNESBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15370-8274
Mailing Address - Country:US
Mailing Address - Phone:724-852-2727
Mailing Address - Fax:724-852-1893
Practice Address - Street 1:20 MILLER LN
Practice Address - Street 2:
Practice Address - City:WAYNESBURG
Practice Address - State:PA
Practice Address - Zip Code:15370-8274
Practice Address - Country:US
Practice Address - Phone:724-852-2727
Practice Address - Fax:724-852-1893
Is Sole Proprietor?:No
Enumeration Date:2019-10-24
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG003961225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist