Healthcare Provider Details

I. General information

NPI: 1871009159
Provider Name (Legal Business Name): HMEA DBA TECHACCESS OF RI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2017
Last Update Date: 05/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 COMSTOCK PKWY
CRANSTON RI
02921
US

IV. Provider business mailing address

161 COMSTOCK PKWY
CRANSTON RI
02921-2002
US

V. Phone/Fax

Practice location:
  • Phone: 401-463-0202
  • Fax:
Mailing address:
  • Phone: 401-463-0202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XE0001X
TaxonomyEnvironmental Modification Occupational Therapist
License NumberOT00524
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: KELLY CHARLEBOIS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 401-463-0202