Individual
MS. MISTY ANN DIVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.C.
Contact information
Practice address
315 S MAIN AVE, BOLIVAR, MO 65613-2052
(417) 326-2902
(417) 326-4555
Mailing address
315 S MAIN AVE, P.O. BOX 909, BOLIVAR, MO 65613-2052
(417) 326-2902
(417) 326-4555
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2003031288
MO
Other
Enumeration date
07/09/2006
Last updated
07/09/2007
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