Provider Demographics
NPI:1881385649
Name:KOBETSKA, DZVENYSLAVA SOFIIA (MASTER OF PSYCHOLOGY)
Entity type:Individual
Prefix:
First Name:DZVENYSLAVA SOFIIA
Middle Name:
Last Name:KOBETSKA
Suffix:
Gender:F
Credentials:MASTER OF PSYCHOLOGY
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Mailing Address - Street 1:3002 SUMMER MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:DOUGLASSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19518-1320
Mailing Address - Country:US
Mailing Address - Phone:610-607-3679
Mailing Address - Fax:
Practice Address - Street 1:1919 COTTMAN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19111-3816
Practice Address - Country:US
Practice Address - Phone:215-745-6511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health