Provider Demographics
NPI:1053081661
Name:ONDRECK, ANGELA D
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:D
Last Name:ONDRECK
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 1:7360 CEDAR KNOLLS DR
Mailing Address - Street 2:
Mailing Address - City:HUBER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:45424-3252
Mailing Address - Country:US
Mailing Address - Phone:937-524-9572
Mailing Address - Fax:
Practice Address - Street 1:7360 CEDAR KNOLLS DR
Practice Address - Street 2:
Practice Address - City:HUBER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:45424-3252
Practice Address - Country:US
Practice Address - Phone:937-524-9572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant