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1992425466
GERALYN PROVENZANO
COVINGTON, LA
NPI
1992425466
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
Enumeration Date
2022-09-02
Last Update Date
2022-09-02
Business Address
GERALYN PROVENZANO
706 W 28TH AVE
COVINGTON, LA 70433-1466
Phone number: 985-898-3329
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Mailing Address
GERALYN PROVENZANO
706 W 28TH AVE
COVINGTON, LA 70433-1466
Phone number:
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