Most Relevant Information
Provider Data
| NPI Number: | 1003491861 |
| Provider Name: | NIKITA GAVRILOV MS, LPC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YP2500X |
| Specialty: | Counselor |
| License Number: | PC012388 |
Most Important Dates
| Enumeration Date: | 03/13/2021 |
| Last Updated: | 03/13/2021 |
Provider Practice Location
705 CONTINENTAL DR
HARLEYSVILLE
PA
194383926
Practice Location Phone/Fax
| Phone: | 2672301338 |
| Fax: |
Provider Mailing Location
705 CONTINENTAL DR
HARLEYSVILLE
PA
194383926
Provider Mailing Phone/Fax
| Phone: | 2672301338 |
| Fax: |