| NPI | 1609630326 |
|---|---|
| Former Legal Business Name | KRISTINA CARLSON |
| Entity Type | Organization |
| Authorized Contact | KRISTINA CARLSON Owner 401-575-8559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2024-02-13 |
| Last Update Date | 2024-02-13 |