NICOLE PROVORNOV

TRUMBULL, CT
NPI1366872129
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: NY  58022604)
Enumeration Date2013-11-14
Last Update Date2021-03-10
Business Address
Mrs. NICOLE PROVORNOV
4291 MADISON AVE
TRUMBULL, CT 06611-2739
Phone number: 917-385-7655
Mailing Address
Mrs. NICOLE PROVORNOV
4291 MADISON AVE
TRUMBULL, CT 06611-2739
Phone number: 917-385-7655
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