Craig Joseph Provost PH.D.

NPI 1801994165 - Psychologist - 103TC0700X

NPI Details
NPI 1801994165
Gender Male
Enumeration Date 09/20/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 11 years ago
Practice Location
4300 W 7TH ST
LITTLE ROCK AR, 72205-5446, US
Phone (501) 257-6599
Fax (501) 257-6602
Business Location
LITTLE ROCK AR, 72227-3846, US
Phone (501) 225-5037
Taxonomy Code 103TC0700X
License State Arkansas
License Number 84-12P
Remove 1801994165 NPI Number

According to our database, Dr. Craig Joseph Provost PH.D. NPI is 1801994165, taxonomy code is 103TC0700X and license number is 84-12P, license state is located at Arkansas. Craig Joseph Provost PH.D. physically located at 4300 W 7th St, Little Rock AR, 72205-5446. NPI Number Craig Joseph Provost PH.D. has the Individual type.

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1801994165 NPI number is provided on an as is basis without warranty of any kind. 1801994165 is maintained by the National Plan & Provider Enumeration System. The contents of Craig Joseph Provost PH.D. are for informational purposes only.