NPI 1003070319

Larisa Surenovna Dzhavakova, MD

Practitioner Mental Health Counselor Philadelphia, PA

Practice location

Address: 1701 a Grant Ave, Philadelphia, PA 19115-3160
Phone: (215) 464-3838
Fax: (215) 464-3899

Registered specialties

Mental Health Counselor Primary

Behavioral Health & Social Service Providers Taxonomy 101YM0800X

Other Counselor providers in Pennsylvania →

Registry record

NPI: 1003070319
Entity type: Individual
Sex (as registered): Female
NPI issued: 16 Jul 2008
Record last updated: 16 Jul 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.