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1114694338
KSENIA USTINOVA
SOUTH LAKE TAHOE, CA
NPI
1114694338
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
104100000X Social Worker
(Licence: CA 118870)
Enumeration Date
2021-08-25
Last Update Date
2024-08-07
Business Address
KSENIA USTINOVA ACSW
2100 ELOISE AVE
SOUTH LAKE TAHOE, CA 96150-4306
Phone number: 530-544-1748
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Mailing Address
KSENIA USTINOVA ACSW
PO BOX 9683
SOUTH LAKE TAHOE, CA 96158-2683
Phone number: 916-248-9264
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