NPI | 1851952725 |
---|---|
Former Name | ILONA NIKOLAYEVNA KALPAKCHI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA MG60973191) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2019-06-21 |
Last Update Date | 2021-04-02 |