Provider Demographics
NPI:1861007445
Name:KRAVCHENKO, SVITLANA (CNIM, R EEG T)
Entity Type:Individual
Prefix:
First Name:SVITLANA
Middle Name:
Last Name:KRAVCHENKO
Suffix:
Gender:F
Credentials:CNIM, R EEG T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8518 HERALDRY ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-2425
Mailing Address - Country:US
Mailing Address - Phone:210-667-8525
Mailing Address - Fax:
Practice Address - Street 1:8518 HERALDRY ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78254-2425
Practice Address - Country:US
Practice Address - Phone:210-667-8525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist