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1760209712
LESLIE DIANE PROVIS
PENSACOLA, FL
NPI
1760209712
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
104100000X Social Worker
Enumeration Date
2024-09-23
Last Update Date
2024-09-23
Business Address
LESLIE DIANE PROVIS MSW
8333 N DAVIS HWY
PENSACOLA, FL 32514-6050
Phone number: 850-474-8756
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Mailing Address
LESLIE DIANE PROVIS MSW
3403 GREEN BRIAR CT APT B
GULF BREEZE, FL 32563-2839
Phone number: 850-292-7909
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