Organization
PROVIDENT INC.
Active
Organization
PROVIDENT INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VALERIE MOORE (INSURANCE SPECIALIST)
(314) 371-6500
Entity
Organization
Contact information
Practice address
3675 W OUTER RD, ARNOLD, MO 63010-5232
(314) 898-0102
(636) 296-3249
Mailing address
2650 OLIVE ST, SAINT LOUIS, MO 63103-1424
(314) 371-6500
(314) 371-1155
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
002589
MO
Other
Enumeration date
12/13/2007
Last updated
12/13/2007
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