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Organization

PROVIDENT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MARIA M WATKINS LPC (COUNSELOR)
(314) 898-0102
Entity
Organization

Contact information

Practice address
3675 W OUTER RD STE 203, ARNOLD, MO 63010-5232
(314) 898-0102
(636) 296-3249
Mailing address
3675 W OUTER RD STE 203, ARNOLD, MO 63010-5232
(314) 898-0102
(636) 296-3249

Taxonomy

Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
2002014019
MO

Other

Enumeration date
09/20/2006
Last updated
08/22/2020
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