Healthcare Provider Details

I. General information

NPI: 1437517141
Provider Name (Legal Business Name): KATHRYN MARQUETTE MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2016
Last Update Date: 02/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1023 POST RD
WARWICK RI
02888-3363
US

IV. Provider business mailing address

87 N BEND ST UNIT 9
PAWTUCKET RI
02860-3181
US

V. Phone/Fax

Practice location:
  • Phone: 401-773-7116
  • Fax:
Mailing address:
  • Phone: 203-232-5974
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW01823
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: