LEAH MARIE PROVOST

SKOWHEGAN, ME
NPI1184403958
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: ME  CNP241205)
Additional Taxonomies163W00000X Registered Nurse
(Licence: ME  RN56408)
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2023-09-21
Last Update Date2024-07-10
Business Address
LEAH MARIE PROVOST PMHNP-BC
224 MALBONS MILLS RD
SKOWHEGAN, ME 04976-4137
Phone number: 207-431-8259
Mailing Address
LEAH MARIE PROVOST PMHNP-BC
224 MALBONS MILLS RD
SKOWHEGAN, ME 04976-4137
Phone number: 207-431-8259