| NPI | 1194166348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA RICHARD Director Of Practice Administration 401-528-0140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry | |
| Enumeration Date | 2013-07-16 |
| Last Update Date | 2013-08-05 |