| 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 |