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Individual
MARIA PROVENZNAO
Active
Individual
MARIA PROVENZNAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
080206-1
NY
Other
Enumeration date
05/12/2014
Last updated
03/11/2016
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