Provider Demographics
NPI:1063537272
Name:DINOVITZER, MIRIAM ROCHELLE (MFT)
Entity type:Individual
Prefix:MRS
First Name:MIRIAM
Middle Name:ROCHELLE
Last Name:DINOVITZER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 NO ROBERTSON BLVD
Mailing Address - Street 2:STE 806
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048
Mailing Address - Country:US
Mailing Address - Phone:310-652-0960
Mailing Address - Fax:310-854-5631
Practice Address - Street 1:116 NO ROBERTSON BLVD
Practice Address - Street 2:STE 806
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048
Practice Address - Country:US
Practice Address - Phone:310-652-0960
Practice Address - Fax:310-854-5631
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC24870106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist