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1952656837
LISA BROCCOLI DEFUSCO
PROVIDENCE, RI
NPI
1952656837
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: RI CSW01449)
Enumeration Date
2012-07-17
Last Update Date
2012-07-17
Business Address
Mrs. LISA BROCCOLI DEFUSCO LCSW
55 HOPE ST
PROVIDENCE, RI 02906-2001
Phone number: 401-331-1350
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Mailing Address
Mrs. LISA BROCCOLI DEFUSCO LCSW
PO BOX 6688
PROVIDENCE, RI 02940-6688
Phone number: 401-331-1350
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