Individual
DR. KAVITA BASAVARAJU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
90 GLEN COVE RD, GREENVALE, NY 11548-1038
(516) 376-5150
Mailing address
378 ELM DR, ROSLYN, NY 11576-3013
(516) 376-5150
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
009982
NY
Other
Enumeration date
11/17/2008
Last updated
11/17/2008
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