Healthcare Provider Details

I. General information

NPI: 1568389591
Provider Name (Legal Business Name): JANET ARLENE ACOSTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 TOLL GATE RD
WARWICK RI
02886-2717
US

IV. Provider business mailing address

92 VILLA AVE
CRANSTON RI
02905-2652
US

V. Phone/Fax

Practice location:
  • Phone: 401-477-9495
  • Fax: 401-205-3582
Mailing address:
  • Phone: 401-477-9495
  • Fax: 401-205-3582

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberLBA00556
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: