Individual
AHAVA DIVINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
1809 S BROADWAY, CAMDEN, NJ 08104-1333
(856) 408-8694
Mailing address
1809 S BROADWAY, CAMDEN, NJ 08104-1333
(856) 633-2474
Taxonomy
Speciality
Code
Description
License number
State
225C00000X
Rehabilitation Counselor
Primary
—
—
Other
Enumeration date
11/07/2024
Last updated
11/07/2024
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