Provider Demographics
NPI:1427807312
Name:CHUSS, KENDRA LEE
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:LEE
Last Name:CHUSS
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 1:457 W LINCOLN ST APT 509
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-6590
Mailing Address - Country:US
Mailing Address - Phone:484-464-7163
Mailing Address - Fax:
Practice Address - Street 1:HOLY FAMILY SENIOR LIVING
Practice Address - Street 2:1200 SPRING STREET
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018
Practice Address - Country:US
Practice Address - Phone:610-865-5595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC018830225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist