| NPI | 1477661130 |
|---|---|
| Other Name | PEGGY MARY DIVINCENZO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0701001917) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: VA 0717000895) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2007-07-31 |