Cynthia Ann Provost, MHS, CCC, SLP/L

NPI #1023366036 in Bradley, Illinois

Provider Information

NPI Number
1023366036
Entity Type
Individual
Name
Cynthia Ann Provost, MHS, CCC, SLP/L
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Speech-Language Pathologist
Credential
MHS, CCC, SLP/L
Enumeration Date
Aug 22, 2012
Last Updated
Aug 22, 2012

Practice Location

Address
400 S KENNEDY DR
Address 2
SUITE 600
ZIP Code
60915-2682
Phone
(815) 935-7496

Specialties & Taxonomy Codes

Specialty
Speech-Language Pathologist

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