THERESA PROVENZANO

PALM COAST, FL
NPI1568989416
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy103K00000X Behavior Analyst
Additional Taxonomies106E00000X Assistant Behavior Analyst
106S00000X Behavior Technician
Enumeration Date2017-08-22
Last Update Date2017-08-22
Business Address
Mrs. THERESA PROVENZANO
515 PALM COAST PKWY SW
PALM COAST, FL 32137-4739
Phone number: 386-951-3044
Mailing Address
Mrs. THERESA PROVENZANO
175 MIDDLE ST UNIT 1201
LAKE MARY, FL 32746-3625
Phone number: 866-610-0580