Connecticut
Department of Consumer Protection
AMY PROVENCAL
Physical Therapist Assistant
License number
199
Date granted
01/04/1996
Date expires
09/30/2014
Class
Physical Therapist Assistant
Status
Active
Address
139 Charter Oak Avenue, East Haven, CT, 06512
ctlicensing.org
ID 4308995
LAST UPDATED 2026-05-13 07:48:27 UTC
LAST UPDATED 2026-05-13 07:48:27 UTC
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