Healthcare Provider Details

I. General information

NPI: 1689049512
Provider Name (Legal Business Name): FRANCINE ANGELA ARCHAMBAULT M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2015
Last Update Date: 12/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 HOWARD AVE
CRANSTON RI
02920-3001
US

IV. Provider business mailing address

530 N MAIN ST
PROVIDENCE RI
02904-5762
US

V. Phone/Fax

Practice location:
  • Phone: 401-462-2592
  • Fax: 401-462-1033
Mailing address:
  • Phone: 401-462-2592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: