Individual
CAITLIN PROVENCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
5300 E ERICKSON DR, TUCSON, AZ 85712-2828
(520) 324-7200
Mailing address
1009 E GREENLEE PL, TUCSON, AZ 85719-1816
(520) 425-0712
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
07/18/2018
Last updated
07/18/2018
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