Individual
JESSICA L DIVINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
220 ESSIE DAVISON DR, CLARINDA, IA 51632-2915
(712) 542-2176
Mailing address
220 ESSIE DAVISON DR, CLARINDA, IA 51632-2915
(712) 542-2176
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2020016805
MO
Other
Enumeration date
04/02/2021
Last updated
04/02/2021
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