MONIQUE PROVENCIO

LAS VEGAS, NV
NPI1346618154
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy251S00000X Community/Behavioral Health
Enumeration Date2015-09-10
Last Update Date2017-04-03
Business Address
-- MONIQUE PROVENCIO
2725 S JONES BLVD SUITE 109
LAS VEGAS, NV 89146-5667
Phone number: 702-758-2992
Mailing Address
-- MONIQUE PROVENCIO
2725 S JONES BLVD SUITE 109
LAS VEGAS, NV 89146-5667
Phone number: 702-758-2992
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