Individual
ASHLEY DIVITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
W7327 ANDERSON AVE, SHAWANO, WI 54166-3836
(715) 526-4700
(715) 526-5442
Mailing address
W7327 ANDERSON AVE, SHAWANO, WI 54166-1143
(715) 526-4700
(715) 526-5542
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
11616
WI
Other
Enumeration date
03/30/2022
Last updated
04/23/2024
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