Jessica Diane Proveaux

NPI #1093338063 in St Augustine, Florida

Provider Information

NPI Number: 1093338063
Entity Type: Individual
Name: Jessica Diane Proveaux
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Analyst
Enumeration Date: May 25, 2020
Last Updated: Mar 21, 2024

Practice Location

Address: 124 CAPULET DR STE 102
City: St Augustine
State: Florida
ZIP Code: 32092-4538
Phone: (904) 429-3859

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X
Behavior Analyst	103K00000X	Primary

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