Individual
MS. MARSHA BINNS PROVALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1111 S JEFFERSON DAVIS PKWY, NEW ORLEANS, LA 70125
(504) 486-2650
Mailing address
1841 LEBOEUF CT, A2-206, NEW ORLEANS, LA 70114-6177
(504) 367-5500
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3420
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1463787
—
LA
Enumeration date
07/21/2006
Last updated
07/08/2007
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