MARY ANITA PROVENCE

INDIANAPOLIS, IN
NPI1326305814
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: IN  34003940A)
Enumeration Date2012-04-20
Last Update Date2012-04-20
Business Address
-- MARY ANITA PROVENCE LCSW
5023 E 56TH ST
INDIANAPOLIS, IN 46226-1474
Phone number: 317-253-7387
Mailing Address
-- MARY ANITA PROVENCE LCSW
PO BOX 55107
INDIANAPOLIS, IN 46205-0107
Phone number: 317-253-7387
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