Individual
SCOTT PROVOST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
60 JODIE RD, FRAMINGHAM, MA 01702-6147
(508) 875-1225
Mailing address
60 JODIE RD, FRAMINGHAM, MA 01702-6147
(508) 875-1225
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1027876
MA
Other
Enumeration date
08/01/2018
Last updated
08/01/2018
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