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1225546831
MICHAEL PROVENZANO
LANSING, MI
NPI
1225546831
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: MI 6401012536)
Enumeration Date
2018-01-17
Last Update Date
2018-01-17
Business Address
MICHAEL PROVENZANO
913 W HOLMES RD STE 200
LANSING, MI 48910-0426
Phone number: 517-887-0226
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Mailing Address
MICHAEL PROVENZANO
913 W HOLMES RD STE 200
LANSING, MI 48910-0426
Phone number: 517-887-0226
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