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1801593199
SHAYNA PROVENCHER
NEW LONDON, CT
NPI
1801593199
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: CT 13552)
Enumeration Date
2023-02-08
Last Update Date
2025-01-06
Business Address
SHAYNA PROVENCHER LCSW
164 HEMPSTEAD ST
NEW LONDON, CT 06320-5638
Phone number: 860-237-3273
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Mailing Address
SHAYNA PROVENCHER LCSW
100 PLAZA CT PO BOX 661
GROTON, CT 06340-5702
Phone number:
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