Individual
MS. LETICIA PROVOST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
4440 GENERAL MEYER AVE, NEW ORLEANS, LA 70131-3529
(504) 361-6500
(504) 361-6489
Mailing address
4442 GENERAL MEYER AVENUE, SUITE 201, NEW ORLEANS, LA 70131
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6027
LA
Other
Enumeration date
04/13/2010
Last updated
04/13/2010
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