GRAYDEN PROVANCE

Peer Specialist

Active Individual
NPI: 1730682410

Practice Address

400 TUSCARAWAS ST W
Canton, OH 44702

Phone: (330) 438-2400

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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