| NPI | 1013630771 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRYSTA JENSEN Licensed Clinical Social Worker 401-787-0217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2022-09-19 |
| Last Update Date | 2022-09-19 |