RICHARD J PROVENZANO

WOODSTOCK, VA
NPI1073605945
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: VA  0904002158)
Enumeration Date2006-09-29
Last Update Date2010-10-27
Business Address
-- RICHARD J PROVENZANO LCSW
227 S MAIN ST
WOODSTOCK, VA 22664-1451
Phone number: 540-335-3715
Mailing Address
-- RICHARD J PROVENZANO LCSW
PO BOX 193
WOODSTOCK, VA 22664-0193
Phone number: 540-335-3715
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