Provider Demographics
NPI:1194093641
Name:DAKOJI, KAVITA DESAI (PHD, LP)
Entity type:Individual
Prefix:DR
First Name:KAVITA
Middle Name:DESAI
Last Name:DAKOJI
Suffix:
Gender:F
Credentials:PHD, LP
Other - Prefix:
Other - First Name:KAVITA
Other - Middle Name:MAHESH
Other - Last Name:DESAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2922 ALDRICH AVE S
Mailing Address - Street 2:APT #328
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-4289
Mailing Address - Country:US
Mailing Address - Phone:419-308-2644
Mailing Address - Fax:612-813-7199
Practice Address - Street 1:2545 CHICAGO AVE S
Practice Address - Street 2:SUITE 306, MAIL STOP 17-306
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-4543
Practice Address - Country:US
Practice Address - Phone:612-813-7634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-12
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TB0200X, 103TC2200X
MNLP5447103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent