Individual
REGINA MARIA KLYACHKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
21350 W 153RD ST, OLATHE, KS 66061-5413
(913) 322-2400
Mailing address
2250 THUNDERSTICK DR STE 1104, LEXINGTON, KY 40505-9009
(859) 254-1035
(859) 254-2075
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2071
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100278340
—
KY
Enumeration date
08/07/2011
Last updated
05/19/2021
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