CRAIG JOSEPH PROVOST

LITTLE ROCK, AR
NPI1801994165
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy103TC0700X Psychologist, Clinical
(Licence: AR  84-12P)
Enumeration Date2006-09-20
Last Update Date2007-07-08
Business Address
Dr. CRAIG JOSEPH PROVOST Ph.D.
4300 W 7TH ST MHSL (116T/LR); CAVHS
LITTLE ROCK, AR 72205-5446
Phone number: 501-257-6599
Mailing Address
Dr. CRAIG JOSEPH PROVOST Ph.D.
17 SUMMERLAND CT
LITTLE ROCK, AR 72227-3846
Phone number: 501-225-5037
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