Provider Demographics
NPI:1306641386
Name:KHVOYEVSKAYA, VIKTORIYA
Entity type:Individual
Prefix:
First Name:VIKTORIYA
Middle Name:
Last Name:KHVOYEVSKAYA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4360 DEERWOOD LAKE PKWY APT 132
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-1095
Mailing Address - Country:US
Mailing Address - Phone:445-228-8550
Mailing Address - Fax:
Practice Address - Street 1:3503 KERNAN BLVD S STE 1
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224-3605
Practice Address - Country:US
Practice Address - Phone:904-417-8395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician