TAVIS CARTER

PROVIDENCE, RI
NPI1700071701
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: RI  LCDP00206)
Enumeration Date2007-09-12
Last Update Date2009-03-27
Business Address
-- TAVIS CARTER LCDP
530 N MAIN ST
PROVIDENCE, RI 02904-5762
Phone number: 401-274-2500
Mailing Address
-- TAVIS CARTER LCDP
528 N MAIN ST
PROVIDENCE, RI 02904-5757
Phone number:
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