Grayden Boyd Provance
Grayden Boyd Provance is a Peer Specialist in Canton, Ohio. Licensed in Ohio. Registered with an NPI since 2018.
- Licensed in
- OH
- In the registry since
- 2018
Practice location Address checks out
400 Tuscarawas St WCanton, OH 44702-2044
Phone: (330) 438-2400
Fax: (330) 438-3003
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Peer Specialist (primary) | Taxonomy 175T00000X · Licence 00495 (OH) |
|---|
Record details
| NPI number | 1730682410 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | March 9, 2018 |
| Last updated in NPPES | March 9, 2018 |
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Amanda Lynn Petersen, CDCA
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Deonna Peterson
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Carrie Ann Plath
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