Provider Demographics
NPI:1689885949
Name:MEST, OLGA VIOLETA (DEVELOPMENTAL THERAP)
Entity Type:Individual
Prefix:MRS
First Name:OLGA
Middle Name:VIOLETA
Last Name:MEST
Suffix:
Gender:F
Credentials:DEVELOPMENTAL THERAP
Other - Prefix:
Other - First Name:OLGA
Other - Middle Name:VIOLETA
Other - Last Name:MEST
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DT
Mailing Address - Street 1:2123 WESLEY E
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201
Mailing Address - Country:US
Mailing Address - Phone:773-593-7379
Mailing Address - Fax:847-328-7494
Practice Address - Street 1:2123 WESLEY
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201
Practice Address - Country:US
Practice Address - Phone:773-593-7379
Practice Address - Fax:847-328-7494
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist