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Individual

CRISTINA DIVENTI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LSW

Contact information

Practice address
1200 W STATE ST, ROCKFORD, IL 61102-2112
(815) 490-1600
(815) 490-1881
Mailing address
1200 W STATE ST, ROCKFORD, IL 61102-2112
(815) 490-1600
(815) 490-1845

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150101625
IL

Other

Enumeration date
05/06/2016
Last updated
07/01/2019
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