Provenzano, Theresa

Provenzano, Theresa is an individual health care provider with primary practice located at 515 Palm Coast Pkwy Sw , Palm Coast FL 32137-4739. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Assistant Behavior Analyst, Behavioral Health & Social Service Providers / Behavior Technician, Behavioral Health & Social Service Providers / Behavioral Analyst. Behavioral Health & Social Service Providers / Behavioral Analyst is her primary health care specialty. Provenzano, Theresa can be contacted via phone (386) 951-3044.

Contact Information

Primary practice address
515 Palm Coast Pkwy Sw Palm Coast FL 32137-4739
Phone: (386) 951-3044
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Assistant Behavior Analyst 106E00000X
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X

Profile Details

NPI number 1568989416
LBN Legal business name Provenzano, Theresa
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 22nd, 2017
Last updated Aug 22nd, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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