Healthcare Provider Details

I. General information

NPI: 1740976430
Provider Name (Legal Business Name): ALEXIA ARRIAZA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2023
Last Update Date: 04/14/2023
Certification Date: 04/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 MANTON AVE
PROVIDENCE RI
02909-5633
US

IV. Provider business mailing address

134 BISHOP HILL RD
JOHNSTON RI
02919-2826
US

V. Phone/Fax

Practice location:
  • Phone: 401-274-6310
  • Fax:
Mailing address:
  • Phone: 401-688-6549
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number02895
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: