| NPI | 1265914477 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE A MCGUIRE Clinical Manager 401-241-3344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 103TC1900X Psychologist Counseling |
| Enumeration Date | 2018-09-04 |
| Last Update Date | 2019-10-23 |