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1477114957
JACQUELYN MARIE PROVENZOLA
HOWELL, MI
NPI
1477114957
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
104100000X Social Worker
Additional Taxonomies
1041C0700X Social Worker, Clinical
(Licence: 6801105007)
Enumeration Date
2019-06-25
Last Update Date
2023-04-18
Business Address
JACQUELYN MARIE PROVENZOLA LMSW
4902 CHILSON RD
HOWELL, MI 48843-9453
Phone number: 248-385-2524
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Mailing Address
JACQUELYN MARIE PROVENZOLA LMSW
4902 CHILSON RD
HOWELL, MI 48843-9453
Phone number: 248-385-2524
Copy
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