JACKIE A PROVENCHER

LONG BEACH, CA
NPI1497397939
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy106H00000X Marriage & Family Therapist
(Licence: CA  79380)
Enumeration Date2019-10-16
Last Update Date2019-10-16
Business Address
Ms. JACKIE A PROVENCHER AMFT
2211 E OCEAN BLVD
LONG BEACH, CA 90803-2440
Phone number: 562-434-4060
Mailing Address
Ms. JACKIE A PROVENCHER AMFT
7025 E EL PASEO ST
LONG BEACH, CA 90815-3507
Phone number:
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