person
Larry G Provence, MA,LPC
Professional Counselor in Prescott Valley, Arizona
NPI 1801078027

Larry G Provence is a Professional Counselor based in Prescott Valley, AZ and is specialized in Professional. Larry G Provence practices in Prescott Valley, AZ and has the professional credentials of MA,LPC. The NPI Number for Larry G Provence is 1801078027 and holds a License No. LPC11598 (Arizona).

The current practice location address for Larry G Provence is 4715 N Stage Way Ln, Prescott Valley, AZ and can be reached out via phone at 928-775-0019. You can also correspond with Larry G Provence through the mailing address at 4715 N STAGE WAY LN, PRESCOTT VALLEY, AZ - 86314-5325 (mailing address contact number: 928-775-0019).

Location: 4715 N Stage Way Ln, Prescott Valley, AZ, 86314-5325
person
Provider Profile Details
NPI Number
1801078027
Provider Name
Larry G Provence
Credential
MA,LPC
Provider Entity Type
Individual
Gender
Male
Address
4715 N Stage Way Ln, Prescott Valley, AZ, 86314-5325
Phone Number
928-775-0019
Fax Number
Provider Enumeration Date
11/29/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
4715 N Stage Way Ln
City
State
Zip
86314-5325
Phone Number
928-775-0019
Fax Number
person
Provider Business Mailing Address Details
Address
4715 N Stage Way Ln
City
State
Zip
86314-5325
Phone Number
928-775-0019
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
LPC11598 (Arizona)
Definition
Definition to come...
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