Jessica Provost
Jessica Provost is a Behavior Technician in Cromwell, Connecticut. Registered with an NPI since 2011.
- In the registry since
- 2011
Practice location Address checks out
162 W St Ste FCromwell, CT 06416-4405
Phone: (860) 613-9930
Fax: (860) 613-9952
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Behavior Technician (primary) | Taxonomy 106S00000X |
|---|
Record details
| NPI number | 1326344193 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | January 26, 2011 |
| Last updated in NPPES | December 29, 2022 |
| Certification date | December 29, 2022 |
| Mailing address | 162 West St Ste F, Cromwell, CT 06416-4405 |
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