Individual
MARIA PROVANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
100 LEON HALL PKWY, HILLSBORO, MO 63050-3419
(636) 789-0000
Mailing address
207 W 2ND ST, PEVELY, MO 63070-2053
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2025023353
MO
Other
Enumeration date
09/04/2025
Last updated
09/04/2025
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