Lateshia Natia Provitt, ALC
Counselor in Montgomery, AL. Individual provider (NPI-1).
NPI number1972395960
StatusActive
Last updated in NPPESMay 19, 2025
Details
- NPI
- 1972395960
- Entity type
- Individual (NPI-1)
- Name
- Ms. Lateshia Natia Provitt
- Credential
- ALC
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 19, 2025
- Certification date
- May 18, 2025
- Last updated
- May 19, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | ALC05234 | AL | Yes |
Practice location
1785 Taliaferro Trl Ste 13Montgomery, AL 36117-7758
Phone 334-467-4983
Mailing address
9153 Saw Tooth LoopPike Road, AL 36064-2374
Phone 334-467-4983
Other practice locations
9153 Saw Tooth Loop
Pike Road, AL 36064-2374
Pike Road, AL 36064-2374
Phone 334-467-4983
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