Individual
JOY E PROVENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 E NARRAMORE AVE, BUCKEYE, AZ 85326-2632
(623) 386-9708
Mailing address
16133 N 170TH AVE, SURPRISE, AZ 85388-1362
(623) 547-9646
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-12558
AZ
Other
Enumeration date
06/02/2019
Last updated
06/02/2019
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