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1629061783
JEANNE PROVENCIO
LAS CRUCES, NM
NPI
1629061783
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: NM 0529)
Enumeration Date
2005-08-24
Last Update Date
2007-07-08
Business Address
-- JEANNE PROVENCIO LPCC
505 S MAIN ST STE. 129
LAS CRUCES, NM 88001-1206
Phone number: 505-525-5644
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Mailing Address
-- JEANNE PROVENCIO LPCC
505 S MAIN ST STE. 129
LAS CRUCES, NM 88001-1206
Phone number: 505-525-5644
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