Provider Demographics
NPI:1407557788
Name:DEVINE, NADIA (MSW)
Entity Type:Individual
Prefix:
First Name:NADIA
Middle Name:
Last Name:DEVINE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63104-4030
Mailing Address - Country:US
Mailing Address - Phone:618-531-3519
Mailing Address - Fax:
Practice Address - Street 1:1920 S 7TH ST
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104-4030
Practice Address - Country:US
Practice Address - Phone:618-531-3519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool