Healthcare Provider Details

I. General information

NPI: 1477333631
Provider Name (Legal Business Name): KRISTINE JOYCE TOIC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2023
Last Update Date: 10/04/2023
Certification Date: 10/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1378 DOUGLAS AVE
NORTH PROVIDENCE RI
02904-4336
US

IV. Provider business mailing address

49 ARMOND WAY
HOPE RI
02831-1130
US

V. Phone/Fax

Practice location:
  • Phone: 401-233-1160
  • Fax:
Mailing address:
  • Phone: 401-574-0635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW00587
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: