Provider Demographics
NPI:1669929469
Name:HAZANOV LAHAV, GALINA
Entity type:Individual
Prefix:
First Name:GALINA
Middle Name:
Last Name:HAZANOV LAHAV
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GALINA
Other - Middle Name:
Other - Last Name:HARIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:800 MERIDIAN DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80523-0001
Mailing Address - Country:US
Mailing Address - Phone:970-491-6053
Mailing Address - Fax:
Practice Address - Street 1:800 MERIDIAN DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80523-0001
Practice Address - Country:US
Practice Address - Phone:970-491-6053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-09
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker