| NPI | 1558934471 |
|---|---|
| Former Name | TONI-MARIE PROVENZANO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: NJ 41YS00308000) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist (Licence: SC SLP.7572SLP) |
| Enumeration Date | 2021-07-19 |
| Last Update Date | 2021-07-19 |