Healthcare Provider Details

I. General information

NPI: 1578285243
Provider Name (Legal Business Name): MISS ALEXANDRIA MAE MAROIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2022
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

69 7TH AVE
WOONSOCKET RI
02895-5034
US

IV. Provider business mailing address

69 7TH AVE
WOONSOCKET RI
02895-5034
US

V. Phone/Fax

Practice location:
  • Phone: 401-309-5502
  • Fax:
Mailing address:
  • Phone: 401-309-5502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW03644
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: