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1336204072
DAVID JON MEDEIROS
PROVIDENCE, RI
NPI
1336204072
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: RI ISW01114)
Enumeration Date
2006-12-22
Last Update Date
2007-07-08
Business Address
Mr. DAVID JON MEDEIROS LICSW
173 WATERMAN ST
PROVIDENCE, RI 02906-3919
Phone number: 401-743-1214
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Mailing Address
Mr. DAVID JON MEDEIROS LICSW
173 WATERMAN ST
PROVIDENCE, RI 02906-3919
Phone number: 401-743-1214
Copy
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