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1780805283
MARCEL A TRISVAN
PROVIDENCE, RI
NPI
1780805283
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: RI LCDP-352)
Enumeration Date
2007-05-01
Last Update Date
2007-07-08
Business Address
Mr. MARCEL A TRISVAN LCDP
CODAC PROVIDENCE 349 HUNTINGTON AVE
PROVIDENCE, RI 02909
Phone number: 401-942-1450
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Mailing Address
Mr. MARCEL A TRISVAN LCDP
31 NELLIE ST
PROVIDENCE, RI 02904
Phone number: 401-270-0000
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