Individual
MS. SHEILA ANN PROVENCAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
201 SCHOOL STREET, FORESTDALE, RI 02824
(401) 257-5628
Mailing address
P.O. BOX 13, 201 SCHOOL STREET, FORESTDALE, RI 02824
(401) 257-5628
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFT00135
RI
Other
Enumeration date
06/18/2010
Last updated
01/05/2011
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