LISA ELLEN PROVOST

EVANSVILLE, IN
NPI1134290208
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: IN  39000109A)
Enumeration Date2006-11-12
Last Update Date2007-07-08
Business Address
Mrs. LISA ELLEN PROVOST MS
6221 PHYSICIANS CT
EVANSVILLE, IN 47715-4031
Phone number: 812-491-7739
Mailing Address
Mrs. LISA ELLEN PROVOST MS
6221 PHYSICIANS CT
EVANSVILLE, IN 47715-4031
Phone number: 812-491-7739
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