Alexis Blythe Provost
ActiveCalifornia license 12121
License
- Licensed by
- California Board of Occupational Therapy
- License number
- 12121
- Status
- Active (Current)
- First issued
- August 26, 2011
- Expires
- August 31, 2028
- License holder
- Alexis Blythe Provost
- Entity type
- Individual
Classifications
- Occupational Therapist Therapy & Rehabilitation
More from the license record
- License type code
- 7101
Contact
5343 Allott Ave
Sherman Oaks, CA 91401
Sherman Oaks, CA 91401
Los Angeles County