Provider Demographics
NPI:1538336540
Name:NOVOZHILOV, LAUREN JOINER (BS)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:JOINER
Last Name:NOVOZHILOV
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:JOINER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 8008
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39303
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:760 WEST MOUNTAIN VIEW STREET
Practice Address - Street 2:
Practice Address - City:ALTADENA
Practice Address - State:CA
Practice Address - Zip Code:91001
Practice Address - Country:US
Practice Address - Phone:626-798-6793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health