MS. Jackie A Provencher, AMFT
MS. Jackie A Provencher, AMFT is a Marriage & Family Therapist in Long Beach, California. Licensed in California. Registered with an NPI since 2019.
- Licensed in
- CA
- In the registry since
- 2019
Practice location Address checks out
2211 E Ocean BlvdLong Beach, CA 90803-2440
Phone: (562) 434-4060
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Marriage & Family Therapist (primary) | Taxonomy 106H00000X · Licence 79380 (CA) |
|---|
Record details
| NPI number | 1497397939 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Credentials | AMFT |
| Sole proprietor | No |
| NPI enumerated | October 16, 2019 |
| Last updated in NPPES | October 16, 2019 |
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