Provider Demographics
NPI:1134614456
Name:HOOD, KIONDRA
Entity type:Individual
Prefix:
First Name:KIONDRA
Middle Name:
Last Name:HOOD
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 1:5906 S KING DR # A3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60637-1320
Mailing Address - Country:US
Mailing Address - Phone:772-729-7449
Mailing Address - Fax:
Practice Address - Street 1:5906 S KING DR # A3
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-1320
Practice Address - Country:US
Practice Address - Phone:772-729-7449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-28
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist