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1700019254
JASON G RODERICK
PROVIDENCE, RI
NPI
1700019254
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2009-09-01
Last Update Date
2012-10-04
Business Address
-- JASON G RODERICK MSW, LICSW
35 S ANGELL ST
PROVIDENCE, RI 02906-5206
Phone number: 401-439-4159
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Mailing Address
-- JASON G RODERICK MSW, LICSW
51 SPRING GARDEN ST
WARWICK, RI 02888-1652
Phone number: 401-439-4159
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