Individual
MR. MICHAEL PATRICK PROVEAUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
20400 COLONEL GLENN RD, LITTLE ROCK, AR 72210-5323
(501) 821-5500
Mailing address
2611 W CAPITOL AVE, LITTLE ROCK, AR 72205-5901
(501) 960-9609
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1667-C
AR
Other
Enumeration date
04/04/2007
Last updated
07/08/2007
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