Provider Demographics
NPI:1013564061
Name:KEFALA, GIANNOULA
Entity Type:Individual
Prefix:MS
First Name:GIANNOULA
Middle Name:
Last Name:KEFALA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:FLAT 1
Mailing Address - Street 2:13 PIERREPOINT ROAD
Mailing Address - City:LONDON
Mailing Address - State:EALING
Mailing Address - Zip Code:W3 9JJ
Mailing Address - Country:GB
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:FLAT 1
Practice Address - Street 2:13 PIERREPOINT ROAD
Practice Address - City:LONDON
Practice Address - State:EALING
Practice Address - Zip Code:W3 9JJ
Practice Address - Country:GB
Practice Address - Phone:778-379-4919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-23
Last Update Date:2019-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty