Facts
- Status
- A
- Credential
- LMHC
- Type
- Individual
- Enumeration date
- 2018-11-13
- Last updated
- 2021-11-16
Licenses
- License RI
- Number not in the file
- License RI
- Number not in the file
Location
- Practice location
- 577 TIOGUE AVE
- City
- COVENTRY RI
- Postal code
- 028165687
- Phone
- 401-644-2819
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.