Jessica Provost
NPI #1326344193 in Cromwell, Connecticut
Provider Information
- NPI Number
- 1326344193
- Entity Type
- Individual
- Name
- Jessica Provost
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Behavior Technician
- Enumeration Date
- Jan 26, 2011
- Last Updated
- Dec 29, 2022
Practice Location
- Address
- 162 WEST ST STE F
- City
- Cromwell
- State
- Connecticut
- ZIP Code
- 06416-4405
- Phone
- (860) 613-9930
Specialties & Taxonomy Codes
| Specialty |
|---|
| Behavior Technician |
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