Provider Demographics
NPI:1902248024
Name:SUBRAHMANIAN, KAVITA JOSHI (PHD)
Entity Type:Individual
Prefix:DR
First Name:KAVITA
Middle Name:JOSHI
Last Name:SUBRAHMANIAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:KAVITA
Other - Middle Name:
Other - Last Name:JOSHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD,
Mailing Address - Street 1:1778 MILLHOUSE RUN
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-8012
Mailing Address - Country:US
Mailing Address - Phone:407-221-0124
Mailing Address - Fax:
Practice Address - Street 1:1778 MILLHOUSE RUN
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-8012
Practice Address - Country:US
Practice Address - Phone:407-221-0124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-18
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019931103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical