Individual
ALEXANDER LOUIS DIVERGILIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.ED, NCC
Contact information
Practice address
59 HOSPITAL RD, NEWNAN, GA 30263-1209
(678) 423-4610
Mailing address
105 GREEN MEADOW LN, FAYETTEVILLE, GA 30215-6504
(678) 382-2732
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/26/2021
Last updated
04/26/2021
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