Individual provider · Type 1 NPI

Larisa Surenovna Dzhavakova, MD

Mental Health Counselor · Philadelphia, PA

NPI number 1003070319 Active

Practice location

1701 A Grant Ave
Philadelphia, PA 19115-3160

Fax (215) 464-3899

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1003070319

Larisa Surenovna Dzhavakova, MD's National Provider Identifier is 1003070319, issued on Jul 16, 2008. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Philadelphia, PA. The record was last updated on Jul 16, 2008.