LISA MARIE PROVOST

FLINT, MI
NPI1861575508
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy103TC0700X Psychologist, Clinical
(Licence: MI  6301010883)
Enumeration Date2006-10-24
Last Update Date2007-07-08
Business Address
-- LISA MARIE PROVOST MA, LLP
2360 S LINDEN RD SUITE 300
FLINT, MI 48532-5420
Phone number: 810-732-0560
Mailing Address
-- LISA MARIE PROVOST MA, LLP
2420 DARWIN LN
SAGINAW, MI 48603-3456
Phone number: 810-892-0784
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