Provider Demographics
NPI:1386341287
Name:GOLOVENZITZ, CHAVIE
Entity type:Individual
Prefix:
First Name:CHAVIE
Middle Name:
Last Name:GOLOVENZITZ
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 1:273 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-4105
Mailing Address - Country:US
Mailing Address - Phone:347-988-7387
Mailing Address - Fax:
Practice Address - Street 1:273 JAMES ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-4105
Practice Address - Country:US
Practice Address - Phone:347-988-7387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-10
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist