Provider Demographics
NPI:1780238071
Name:THAKKAR, DIVYA HITESH
Entity type:Individual
Prefix:
First Name:DIVYA HITESH
Middle Name:
Last Name:THAKKAR
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 1:1662 LOBLOLLY CT APT 147
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-7636
Mailing Address - Country:US
Mailing Address - Phone:917-306-6602
Mailing Address - Fax:
Practice Address - Street 1:87 N CANTON RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44305-3838
Practice Address - Country:US
Practice Address - Phone:330-733-7993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-25
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health