MS. Misty Ann Divin, L.P.C.

NPI #1114950482 in Bolivar, Missouri

Provider Information

NPI Number: 1114950482
Entity Type: Individual
Name: MS. Misty Ann Divin, L.P.C.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Professional
Credential: L.P.C.
Enumeration Date: Jul 9, 2006
Last Updated: Jul 9, 2007

Practice Location

Address: 315 S MAIN AVE
City: Bolivar
State: Missouri
ZIP Code: 65613-2052
Phone: (417) 326-2902

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Professional — Professional	101YP2500X	Primary

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