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Individual
STELLA WASSILLIE
Active
Individual
STELLA WASSILLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DA4442
—
AK
Enumeration date
10/20/2011
Last updated
10/20/2011
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