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1427203736
LIZA CRISTIN PROVENZANO
JACKSONVILLE, FL
NPI
1427203736
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: FL mh9038)
Enumeration Date
2008-12-01
Last Update Date
2015-07-02
Business Address
Mrs. LIZA CRISTIN PROVENZANO LMHC
13400 SUTTON PARK DR S SUITE 1504
JACKSONVILLE, FL 32224-0236
Phone number: 904-568-5826
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Mailing Address
Mrs. LIZA CRISTIN PROVENZANO LMHC
912 COLLINSWOOD DR W
JACKSONVILLE, FL 32225-0861
Phone number: 904-568-5826
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