Individual
MS. KIMBERLY ANNE PROVOST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCABA
Contact information
Practice address
147 ALLEN BROOK LN STE 104, WILLISTON, VT 05495-9211
(802) 876-7111
(802) 448-6905
Mailing address
147 ALLEN BROOK LN STE 104, WILLISTON, VT 05495-9211
(802) 876-7111
(802) 448-6905
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
VT
Other
Enumeration date
06/20/2022
Last updated
06/20/2022
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