Individual
SHERRI LYNN PROVENCAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
555 PROSPECT ST, PAWTUCKET, RI 02860-6200
(401) 729-6200
(401) 729-6203
Mailing address
555 PROSPECT ST, PAWTUCKET, RI 02860-6200
(401) 729-6200
(401) 729-6203
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PS01063
RI
Other
Enumeration date
01/20/2009
Last updated
07/15/2010
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