DORA PROVENCIO

FRESNO, CA
NPI1306055447
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: CA  8793)
Enumeration Date2007-05-22
Last Update Date2007-07-08
Business Address
-- DORA PROVENCIO
7300 N FRESNO ST
FRESNO, CA 93720-2941
Phone number: 559-448-3612
Mailing Address
-- DORA PROVENCIO
37118 DUNLAP RD
SQUAW VALLEY, CA 93675-9606
Phone number: 559-338-9121
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