Individual
ALEXIS PROVETTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
190 POND VIEW LN, SMITHTOWN, NY 11787-5200
(631) 656-6411
Mailing address
190 POND VIEW LN, SMITHTOWN, NY 11787-5200
(631) 656-6411
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
020477
NY
Other
Enumeration date
07/17/2007
Last updated
07/30/2014
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