Provider Demographics
NPI:1356547244
Name:DHIRAJLAL, NIMITA (MA)
Entity type:Individual
Prefix:
First Name:NIMITA
Middle Name:
Last Name:DHIRAJLAL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:627 RUSSELL WAY
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93110-1538
Mailing Address - Country:US
Mailing Address - Phone:805-259-6594
Mailing Address - Fax:
Practice Address - Street 1:627 RUSSELL WAY
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93110-1538
Practice Address - Country:US
Practice Address - Phone:805-259-6594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling