CHRISTINE MARIE PROVENCHER

SAN DIEGO, CA
NPI1689375669
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: CA  SP34708)
Enumeration Date2023-03-15
Last Update Date2023-03-15
Business Address
CHRISTINE MARIE PROVENCHER
13223 BLACK MOUNTAIN RD # 1358
SAN DIEGO, CA 92129-2698
Phone number: 619-672-8387
Mailing Address
CHRISTINE MARIE PROVENCHER
13223 BLACK MOUNTAIN RD # 1358
SAN DIEGO, CA 92129-2698
Phone number:
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