Provider Demographics
NPI:1831325893
Name:DI VINCENZO, VERA (MA)
Entity type:Individual
Prefix:MS
First Name:VERA
Middle Name:
Last Name:DI VINCENZO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 E LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-2723
Mailing Address - Country:US
Mailing Address - Phone:610-873-1005
Mailing Address - Fax:610-873-1902
Practice Address - Street 1:1140 MCDERMOTT DR
Practice Address - Street 2:SUITE 100/101
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-4043
Practice Address - Country:US
Practice Address - Phone:610-430-6141
Practice Address - Fax:610-430-7708
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-04
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No251B00000XAgenciesCase Management