Individual
ILANA RIVKOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
322 LAMAR AVE STE 220, CHARLOTTE, NC 28204-2436
(704) 914-5910
Mailing address
322 LAMAR AVE STE 220, CHARLOTTE, NC 28204-2436
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A21177
NC
Other
Enumeration date
03/22/2025
Last updated
03/22/2025
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