Individual
STEFANIE PROVOST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3211 GRANT LINE RD STE 15, NEW ALBANY, IN 47150-2175
(502) 417-9830
Mailing address
3211 GRANT LINE RD STE 15, NEW ALBANY, IN 47150-2175
(502) 417-9830
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
09/16/2015
Last updated
09/16/2015
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