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Individual
JOSEPH DIVACK
Active
Individual
JOSEPH DIVACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW002485E
PA
Other
Enumeration date
02/04/2009
Last updated
02/04/2009
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