Individual provider · Type 1 NPI
Larry G. Provence, M.A., L.P.C.
Professional Counselor · Prescott Valley, AZ
NPI number
1801078027
Active
Practice location
4715 N Stage Way Ln
Prescott Valley, AZ 86314-5325
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | LPC11598 (AZ) |
Professional Counselor: Definition to come...
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About NPI 1801078027
Larry G. Provence, M.A., L.P.C.'s National Provider Identifier is 1801078027, issued on Nov 29, 2007. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Prescott Valley, AZ. The record was last updated on Nov 29, 2007.