MISS Regina Ann Provisiero, MA/CCC/SLP
NPI #1457596207 in Port Jefferson, New York
Provider Information
- NPI Number
- 1457596207
- Entity Type
- Individual
- Name
- MISS Regina Ann Provisiero, MA/CCC/SLP
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Speech-Language Pathologist
- Credential
- MA/CCC/SLP
- Enumeration Date
- Dec 9, 2008
- Last Updated
- Dec 9, 2008
Practice Location
- Address
- 220 WINDWARD CT N
- City
- Port Jefferson
- State
- New York
- ZIP Code
- 11777-2323
- Phone
- (631) 525-7514
Specialties & Taxonomy Codes
| Specialty |
|---|
| Speech-Language Pathologist |
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