Provider Demographics
NPI:1538876461
Name:MOKHNACH, DARIA SERGEYEVNA
Entity type:Individual
Prefix:
First Name:DARIA
Middle Name:SERGEYEVNA
Last Name:MOKHNACH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2615 E 16TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-3805
Mailing Address - Country:US
Mailing Address - Phone:718-305-1471
Mailing Address - Fax:
Practice Address - Street 1:2615 E 16TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-3805
Practice Address - Country:US
Practice Address - Phone:718-305-1471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NAOtherNA