CHANELL RAVEN BOURNE

PROVIDENCE, RI
NPI1356089775
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
(Licence: RI  LP05536)
Enumeration Date2022-05-25
Last Update Date2022-05-25
Business Address
CHANELL RAVEN BOURNE MD
593 EDDY ST
PROVIDENCE, RI 02903-4923
Phone number: 401-444-5180
Mailing Address
CHANELL RAVEN BOURNE MD
593 EDDY ST
PROVIDENCE, RI 02903-4923
Phone number:
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