CATHERINE PROVENZANO

PORT JEFFERSON STATION, NY
NPI1508269838
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: NY  081438)
Enumeration Date2014-10-01
Last Update Date2014-10-01
Business Address
-- CATHERINE PROVENZANO
1050 HALLOCK AVE
PORT JEFFERSON STATION, NY 11776-1214
Phone number: 631-487-5162
Mailing Address
-- CATHERINE PROVENZANO
1050 HALLOCK AVE
PORT JEFFERSON STATION, NY 11776-1214
Phone number: 631-487-5162
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