GINA PROVISIERO

LEHIGHTON, PA
NPI1093262727
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
Additional Taxonomies104100000X Social Worker
(Licence: PA  SW133460)
Enumeration Date2016-09-11
Last Update Date2019-08-29
Business Address
GINA PROVISIERO LCSW
777 BLAKESLEE BLVD DR E SUITE 3
LEHIGHTON, PA 18235
Phone number: 631-512-1264
Mailing Address
GINA PROVISIERO LCSW
32 W WALTER ST FL 1
SUMMIT HILL, PA 18250-1412
Phone number: 631-512-1264