Individual
JILL ASHLEY DIVITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
12634 ANGLING RD, SUITE E, EDINBORO, PA 16412-1369
(814) 734-7094
(814) 734-3080
Mailing address
12634 ANGLING RD, SUITE E, EDINBORO, PA 16412-1369
(814) 734-7094
(814) 734-3080
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PC005868
PA
Other
Enumeration date
07/07/2011
Last updated
07/07/2011
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