Lori A Provenzano
NPI #1104159862 in Willoughby, Ohio
Provider Information
- NPI Number
- 1104159862
- Entity Type
- Individual
- Name
- Lori A Provenzano
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Case Manager/Care Coordinator
- Enumeration Date
- Sep 14, 2009
- Last Updated
- Jan 29, 2014
Practice Location
- Address
- 5105 SOM CENTER RD
- City
- Willoughby
- State
- Ohio
- ZIP Code
- 44094-4203
- Phone
- (440) 975-4646
Specialties & Taxonomy Codes
| Specialty |
|---|
| Case Manager/Care Coordinator |
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