Provider Demographics
NPI:1770755407
Name:MIKHALCHENKO HARVARD, YULIA VITALYEVNA
Entity type:Individual
Prefix:
First Name:YULIA
Middle Name:VITALYEVNA
Last Name:MIKHALCHENKO HARVARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:YULIA
Other - Middle Name:
Other - Last Name:HARVARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:12420 ACHE RIDGE LANE
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12420 ACHE RIDGE LANE
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703
Practice Address - Country:US
Practice Address - Phone:919-933-7720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8017235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist