Gina Provisiero, LCSW
NPI #1093262727 in Lehighton, Pennsylvania
Provider Information
- NPI Number
- 1093262727
- Entity Type
- Individual
- Name
- Gina Provisiero, LCSW
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Social Worker - Clinical
- Credential
- LCSW
- Enumeration Date
- Sep 11, 2016
- Last Updated
- Aug 29, 2019
Practice Location
- Address
- 777 BLAKESLEE BLVD DR E
- Address 2
- SUITE 3
- City
- Lehighton
- State
- Pennsylvania
- ZIP Code
- 18235
- Phone
- (631) 512-1264
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker |
| Social Worker - Clinical — Clinical |
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