Healthcare Provider Details

I. General information

NPI: 1225464209
Provider Name (Legal Business Name): INNER YOU LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2013
Last Update Date: 05/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1023 POST RD
WARWICK RI
02888
US

IV. Provider business mailing address

1023 POST RD
WARWICK RI
02888
US

V. Phone/Fax

Practice location:
  • Phone: 401-773-7116
  • Fax: 401-773-7106
Mailing address:
  • Phone: 401-773-7116
  • Fax: 401-773-7106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: KERRI MOWBRAY
Title or Position: OWNER
Credential:
Phone: 401-773-7116