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1770794943
GREGORY JOSEPH PROVENZANO
HAMILTON, NJ
NPI
1770794943
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: NJ 37PC00312600)
Enumeration Date
2007-05-26
Last Update Date
2007-07-08
Business Address
Mr. GREGORY JOSEPH PROVENZANO M.A., LPC
3379 QUAKERBRIDGE RD STE 101
HAMILTON, NJ 08619-1246
Phone number: 609-439-0777
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Mailing Address
Mr. GREGORY JOSEPH PROVENZANO M.A., LPC
74 CHESTNUT CT
HILLSBOROUGH, NJ 08844-1403
Phone number: 908-227-7269
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