Individual
CHRISTIAN A PROVENCE-HARMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
953 S CARRIAGE AVE, SPRINGFIELD, MO 65809-1460
(620) 875-0784
Mailing address
953 S CARRIAGE AVE, SPRINGFIELD, MO 65809-1460
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2019034408
MO
Other
Enumeration date
09/25/2019
Last updated
07/08/2022
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