| NPI | 1043660202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL COLE PENDERGAST Licensed Independent Social Worker 401-301-4526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: RI ISW01338) |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2016-06-20 |