Individual provider · Type 1 NPI
Elizabeth Rose Provost, RADT
Addiction (Substance Use Disorder) Counselor · Stockton, CA
NPI number
1851182117
Active
Practice location
3120 E Anita St
Stockton, CA 95205-3905
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 19037 (CA) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
2 other providers at this address
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About NPI 1851182117
Elizabeth Rose Provost, RADT's National Provider Identifier is 1851182117, issued on May 15, 2025. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Stockton, CA. The record was last updated on May 15, 2025.