MANUEL PROVENCIO

SCOTTSDALE, AZ
NPI1780426122
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker Clinical
(Licence: AZ  LMSW-20309)
Enumeration Date2024-06-07
Last Update Date2024-06-07
Business Address
MANUEL PROVENCIO LMSW
1375 N SCOTTSDALE RD STE 200
SCOTTSDALE, AZ 85257-3429
Phone number: 480-877-9284
Mailing Address
MANUEL PROVENCIO LMSW
22888 E DESERT HILLS DR
QUEEN CREEK, AZ 85142-8898
Phone number: 480-570-0370
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