Gina Marie Divincenzo, LCSW

NPI #1912066416 in Syosset, New York

Provider Information

NPI Number
1912066416
Entity Type
Individual
Name
Gina Marie Divincenzo, LCSW
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Social Worker - Clinical
Credential
LCSW
Enumeration Date
Dec 8, 2006
Last Updated
Sep 1, 2016

Practice Location

Address
175 JERICHO TPKE
Address 2
STE 213
ZIP Code
11791-4501
Phone
(631) 316-3965

Specialties & Taxonomy Codes

Specialty
Social Worker - ClinicalClinical

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