License holder summary

LISA MARIE PROVOST is a Psychologist - Master's Ltd. Psychologist Educ Ltd licensed to practice in Michigan. The address on file for LISA MARIE PROVOST is Beaverton, MI 48612.

Michigan

Department of Licensing and Regulation

LISA MARIE PROVOST
Psychologist - Master's Ltd. Psychologist Educ Ltd
License number
6301010883
Class
Psychologist - Master's Ltd. Psychologist Educ Ltd
Status
Voided
Address
Beaverton, MI 48612
michiganlicensing.org
ID 26021212
LAST UPDATED 2026-05-10 12:36:07 UTC

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