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1962436519
MATTHEW P PROVOST
CRANSTON, RI
NPI
1962436519
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: RI SP00739)
Enumeration Date
2006-07-10
Last Update Date
2020-07-30
Business Address
MATTHEW P PROVOST MS,CCC-SLP
161 COMSTOCK PKWY
CRANSTON, RI 02921-2002
Phone number: 401-463-0202
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Mailing Address
MATTHEW P PROVOST MS,CCC-SLP
161 COMSTOCK PKWY
CRANSTON, RI 02921-2002
Phone number: 401-463-0202
Copy
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