| NPI | 1376276832 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MADRONE B. PHOENIX Owner 401-441-5834 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 103T00000X Psychologist | |
| 103TC0700X Psychologist, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 101Y00000X Counselor | |
| 101YM0800X Counselor, Mental Health | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2022-07-02 |
| Last Update Date | 2022-10-13 |