Ryan Provencher
NPI #1265235220 in Banning, California
Provider Information
- NPI Number
- 1265235220
- Entity Type
- Individual
- Name
- Ryan Provencher
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Counselor - School
- Enumeration Date
- Mar 27, 2025
- Last Updated
- Mar 27, 2025
Practice Location
- Address
- 1151 W WILSON ST
- City
- Banning
- State
- California
- ZIP Code
- 92220-4378
- Phone
- (951) 922-0250
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - School — School |
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