Maria Provenznao, LCSW

NPI #1013328228 in Bronx, New York

Provider Information

NPI Number: 1013328228
Entity Type: Individual
Name: Maria Provenznao, LCSW
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Social Worker - Clinical
Credential: LCSW
Enumeration Date: May 12, 2014
Last Updated: Mar 11, 2016

Practice Location

Address: 981 MORRIS PARK AVENUE
City: Bronx
State: New York
ZIP Code: 10462
Phone: (646) 225-0830

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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