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Individual

DR. EKATERINA PIVOVAROVA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
1 DEVONSHIRE PL, BOSTON, MA 02109-3510
(609) 529-0093
Mailing address
1 DEVONSHIRE PL APT 2903, BOSTON, MA 02109-3538
(609) 529-0093

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
9853
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NONE
NONE
Enumeration date
05/09/2018
Last updated
06/16/2018
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