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1649869272
ASHLEY PROVENCIO
CHEYENNE, WY
NPI
1649869272
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2021-01-18
Last Update Date
2021-01-18
Business Address
ASHLEY PROVENCIO
1920 THOMES AVE STE 110
CHEYENNE, WY 82001-3543
Phone number: 210-823-3808
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Mailing Address
ASHLEY PROVENCIO
1516 E 17TH ST
CHEYENNE, WY 82001-4920
Phone number: 210-823-3808
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