Provider Demographics
NPI:1417461393
Name:KONOVALOVA, ALLISON CHRISTINA (LMFT)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:CHRISTINA
Last Name:KONOVALOVA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2005 SANS SOUCI BLVD APT 301
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-3023
Mailing Address - Country:US
Mailing Address - Phone:561-497-8178
Mailing Address - Fax:
Practice Address - Street 1:2005 SANS SOUCI BLVD APT 301
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-3023
Practice Address - Country:US
Practice Address - Phone:561-497-8178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-29
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT3338106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty