John Devivo

NPI #1205175791 in Milford, Michigan

Provider Information

NPI Number: 1205175791
Entity Type: Individual
Name: John Devivo
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker - Clinical
Enumeration Date: Feb 5, 2013
Last Updated: Feb 5, 2013

Practice Location

Address: 120 S MAIN ST
Address 2: SUITE C
City: Milford
State: Michigan
ZIP Code: 48381-1975
Phone: (248) 390-5791

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Counselor - Professional — Professional	101YP2500X
Social Worker - Clinical — Clinical	1041C0700X	Primary
Marriage & Family Therapist	106H00000X

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