Search › Wisconsin › 104100000X
Beth Provost, LCSW, LMSW
NPI 1194187757 · on the registry since 2016 · sole proprietor
Practice
- Address
- 1060a Lowell Dr
Oconomowoc, WI 53066 - Phone
- (262) 443-7917
Registry record
- Primary taxonomy
- 104100000X
104100000X
- Also registered as
- 104100000X
1041C0700X
171M00000X - Licence states on file
- IA, WI
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2024-12-10
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin