NPI | 1154571206 |
---|---|
Former Name | KSENIYA VLADIMIROVNA ISHINA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW 61317) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2008-09-25 |
Last Update Date | 2020-05-28 |