Individual
NIKKI DONNELLA DIVIRGILIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LGSW
Contact information
Practice address
445 BROADWAY AVE STE A, ST PAUL PARK, MN 55071-1554
(122) 461-2242
Mailing address
1236 1ST ST, ST PAUL PARK, MN 55071-1735
(612) 205-8834
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
11/08/2017
Last updated
05/29/2019
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