Individual
LINDSAY PROVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
1505 15TH ST STE C, LOS ALAMOS, NM 87544-3000
(505) 662-3264
Mailing address
259 RIM RD, LOS ALAMOS, NM 87544-2934
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CMH0196091
NM
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
09/28/2015
Last updated
03/16/2020
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