JOHN FRANCIS PROVOST

HAUPPAUGE, NY
NPI1023129947
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: NY  R0136841)
Enumeration Date2006-08-31
Last Update Date2007-07-08
Business Address
Mr. JOHN FRANCIS PROVOST LCSW Licensed Certif
750 VETERANS HIGHWAY SUITE 205
HAUPPAUGE, NY 11788-2943
Phone number: 631-724-5522
Mailing Address
Mr. JOHN FRANCIS PROVOST LCSW Licensed Certif
77 RIDGE ROAD
SOUTHAMPTON, NY 11968-3608
Phone number: 631-724-5522
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