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1356919344
KARISSA ANN PROVOST
SANTA CLARITA, CA
NPI
1356919344
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: CA 53366)
Enumeration Date
2021-06-15
Last Update Date
2021-06-15
Business Address
KARISSA ANN PROVOST
26330 DIAMOND PL STE 130
SANTA CLARITA, CA 91350-5819
Phone number: 818-501-3512
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Mailing Address
KARISSA ANN PROVOST
26330 DIAMOND PL STE 130
SANTA CLARITA, CA 91350-5819
Phone number: 818-501-3512
Copy
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