| NPI | 1467190496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA GORDON Rcm Director 401-443-5107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 364SP0808X Clinical Nurse Specialist, Psych/Mental Health | |
| Enumeration Date | 2022-05-20 |
| Last Update Date | 2024-01-18 |