Provider Demographics
NPI:1013524669
Name:KONESKY, WESLEY HOLMES (M ED, ED S)
Entity Type:Individual
Prefix:MRS
First Name:WESLEY
Middle Name:HOLMES
Last Name:KONESKY
Suffix:
Gender:F
Credentials:M ED, ED S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1649 SAINT GEORGE CIR
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-5234
Mailing Address - Country:US
Mailing Address - Phone:419-494-6656
Mailing Address - Fax:
Practice Address - Street 1:5600 MONROE ST STE 103B
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2795
Practice Address - Country:US
Practice Address - Phone:419-885-5952
Practice Address - Fax:419-885-7630
Is Sole Proprietor?:No
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP00660103TS0200X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool