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1942988332
JENESSA RAE PROVENCE
SAN DIEGO, CA
NPI
1942988332
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: CA RBT-23-281459)
Enumeration Date
2023-07-06
Last Update Date
2023-07-06
Business Address
Ms. JENESSA RAE PROVENCE
2445 TRUXTUN RD
SAN DIEGO, CA 92106-6153
Phone number: 619-633-2119
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Mailing Address
Ms. JENESSA RAE PROVENCE
2312 PALERMO DR
SAN DIEGO, CA 92106-1247
Phone number: 619-849-9195
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