Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | PY 8419 | FL |
N | 103G00000X | Clinical Psychologist | PY 8419 | FL |
N | 103TC0700X | Clinical Psychologist | PY 8419 | FL |
NPI | 1144505819 |
---|---|
Provider Name | Dr. Divya Ravin Nawalrai |
First Address | Gainesville, FL 32608-1135 |
Second Address | Gainesville, FL 32608-1135 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2011 |
Last Update Date | 13/10/2011 |