GRAYDEN PROVANCE
Peer Specialist
Active
Individual
NPI: 1730682410
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Peer Specialist | 175T00000X | Yes | 00495 (OH) |
Frequently Asked Questions
NPI 1730682410 is the National Provider Identifier for GRAYDEN PROVANCE, a Peer Specialist provider located in Canton, OH. This NPI was enumerated on March 9, 2018.
GRAYDEN PROVANCE practices at 400 TUSCARAWAS ST W, Canton, OH 44702.
Quick Facts
- NPI
- 1730682410
- Type
- Individual
- Enumerated
- Mar 9, 2018
- Last Updated
- Mar 9, 2018
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