Individual
DR. PAUL JOHN DIVINCENZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D
Contact information
Practice address
5311 NORTHFIELD RD, BEDFORD HTS, OH 44146-1135
(216) 518-3900
Mailing address
1019 HILLCREEK LN, GATES MILLS, OH 44040-9630
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3923
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0443756
—
OH
Enumeration date
09/16/2006
Last updated
07/09/2007
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