Individual
MS. LATESHIA NATIA PROVITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ALC
Contact information
Practice address
1785 TALIAFERRO TRL STE 13, MONTGOMERY, AL 36117-7758
(334) 467-4983
Mailing address
9153 SAW TOOTH LOOP, PIKE ROAD, AL 36064-2374
(334) 467-4983
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
ALC05234
AL
Other
Enumeration date
05/19/2025
Last updated
05/19/2025
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