MS. JACKIE PROVENCHER, AMFT
Marriage & Family Therapist
Active
Individual
NPI: 1497397939
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | Yes | 79380 (CA) |
Frequently Asked Questions
NPI 1497397939 is the National Provider Identifier for MS. JACKIE PROVENCHER, AMFT, a Marriage & Family Therapist provider located in Long Beach, CA. This NPI was enumerated on October 16, 2019.
MS. JACKIE PROVENCHER, AMFT practices at 2211 E OCEAN BLVD, Long Beach, CA 90803.
Quick Facts
- NPI
- 1497397939
- Type
- Individual
- Enumerated
- Oct 16, 2019
- Last Updated
- Oct 16, 2019
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