HEATHER LYNNE PROVENCE

NEW PROVIDENCE, NJ
NPI1295221612
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: NJ  26NJ01289400)
Additional Taxonomies363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: NY  F402394-1)
Enumeration Date2018-07-09
Last Update Date2023-07-03
Business Address
HEATHER LYNNE PROVENCE PMHNP
890 MOUNTAIN AVE BEHAVIORAL HEALTH & COGNITIVE THERAPY
NEW PROVIDENCE, NJ 07974
Phone number: 908-277-8900
Mailing Address
HEATHER LYNNE PROVENCE PMHNP
1 DIAMOND HILL RD
BERKELEY HEIGHTS, NJ 07922-2104
Phone number: 908-273-4300