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Jeanette Provenza I
Mental Health Counselor in Lutz, Florida
NPI 1710334008

Jeanette Provenza I is a Mental Health Counselor based in Palm Harbor, FL and is specialized in Mental Health. Jeanette Provenza I practices in Lutz, FL. The NPI Number for Jeanette Provenza I is 1710334008 and holds a License No. (Florida).

The current practice location address for Jeanette Provenza I is 1515 Michelin Ct, Lutz, FL and can be reached out via phone at 813-949-3904.

Location: 1515 Michelin Ct, Lutz, FL, 34685-2355
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1710334008
Provider Name
Jeanette Provenza I
Credential
Provider Entity Type
Individual
Gender
Female
Address
1515 Michelin Ct, Lutz, FL, 34685-2355
Phone Number
813-949-3904
Fax Number
Provider Enumeration Date
05/17/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1515 Michelin Ct
City
Lutz
State
Florida
Zip
33549-7533
Phone Number
813-949-3904
Fax Number
person
Provider Business Mailing Address Details
Address
1515 Michelin Ct
City
Lutz
State
Florida
Zip
33549-7533
Phone Number
813-949-3904
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
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