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Individual
MS. VIRGINIA LILLIAN DURIVAGE
Active
Individual
MS. VIRGINIA LILLIAN DURIVAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
27476
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D9337434
CA DRIVERS LICENSE
CA
Enumeration date
08/20/2012
Last updated
08/20/2012
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