MONIQUE NELLIE PROVENCIO

STOCKTON, CA
NPI1346618154
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: CA  ASW136999)
Additional Taxonomies1041C0700X Social Worker, Clinical
(Licence: IL  150.118978)
Enumeration Date2015-09-10
Last Update Date2026-02-11
Business Address
Ms. MONIQUE NELLIE PROVENCIO
430 N PILGRIM ST
STOCKTON, CA 95205-4428
Phone number: 000-000-0000
Mailing Address
Ms. MONIQUE NELLIE PROVENCIO
430 N PILGRIM ST
STOCKTON, CA 95205-4428
Phone number: