Individual
ELIANE PROVENCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NHP-BC
Contact information
Practice address
345 N MAIN ST, NEIHA, WEST HARTFORD, CT 06117-2515
(860) 547-1489
Mailing address
21 ROCKWELL RD, STAFFORD SPRINGS, CT 06076-4513
(860) 888-8613
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
RND20007152
NV
Other
Enumeration date
10/21/2013
Last updated
10/21/2013
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