| NPI | 1114643475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH PINCINCE Administrator 401-770-3813 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2022-10-18 |
| Last Update Date | 2022-10-18 |