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Individual
JOHN DEVIVO
Active
Individual
JOHN DEVIVO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
6801046519
MI
101YP2500X
Professional Counselor
6801046519
MI
1041C0700X
Clinical Social Worker
Primary
6801046519
MI
106H00000X
Marriage & Family Therapist
6801046519
MI
Other
Enumeration date
02/05/2013
Last updated
02/05/2013
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