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Organization
PROVOST PSYCHOTHERAPY
Active
Organization
PROVOST PSYCHOTHERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH ERIN PROVOST LPC (CLINICAL DIRECTOR)
(713) 302-1348
Entity
Organization
Contact information
Practice address
1300 BAY AREA BLVD STE B150-28, HOUSTON, TX 77058-2505
(325) 603-9322
Mailing address
1300 BAY AREA BLVD STE B150-28, HOUSTON, TX 77058-2505
(325) 603-9322
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
10/29/2020
Last updated
10/29/2020
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