Provider Demographics
NPI:1912786948
Name:PATEL, DHAVALKUMAR SUBHASHBHAI
Entity Type:Individual
Prefix:
First Name:DHAVALKUMAR
Middle Name:SUBHASHBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:STORY CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50248-1565
Mailing Address - Country:US
Mailing Address - Phone:641-220-6550
Mailing Address - Fax:
Practice Address - Street 1:515 GRAND AVE STE 101
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-6061
Practice Address - Country:US
Practice Address - Phone:888-336-9661
Practice Address - Fax:319-200-2516
Is Sole Proprietor?:No
Enumeration Date:2023-09-28
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health