EMILY PROVENZANO

STATEN ISLAND, NY
NPI1104105683
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: NY  1816016)
Enumeration Date2011-08-15
Last Update Date2012-08-28
Business Address
-- EMILY PROVENZANO
1535 RICHMOND AVE
STATEN ISLAND, NY 10314-1520
Phone number: 718-556-1616
Mailing Address
-- EMILY PROVENZANO
418 ROBINSON AVE
STATEN ISLAND, NY 10312-5142
Phone number:
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