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1326242652
JESSICA E PROVOST
APEX, NC
NPI
1326242652
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist
(Licence: NC 7545)
Enumeration Date
2007-06-12
Last Update Date
2009-08-06
Business Address
JESSICA E PROVOST M.S. CCC-SLP
6033 LARBOARD DR.
APEX, NC 27539-4115
Phone number: 919-329-7733
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Mailing Address
JESSICA E PROVOST M.S. CCC-SLP
6033 LARBOARD DR.
APEX, NC 27539-4115
Phone number: 919-329-7733
Copy
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