Provider Demographics
NPI:1942656343
Name:KOLEVSKI, MONICA
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:
Last Name:KOLEVSKI
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 1:45527 HEATHERWOODE LN
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044-4164
Mailing Address - Country:US
Mailing Address - Phone:586-764-3330
Mailing Address - Fax:
Practice Address - Street 1:45527 HEATHERWOODE LN
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48044-4164
Practice Address - Country:US
Practice Address - Phone:586-764-3330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-04
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other