Healthcare Provider Details

I. General information

NPI: 1609700202
Provider Name (Legal Business Name): VICTORIA GENDRON CPD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 CLINTON ST
WOONSOCKET RI
02895-3223
US

IV. Provider business mailing address

87 ARLAND CT
WOONSOCKET RI
02895-2627
US

V. Phone/Fax

Practice location:
  • Phone: 401-684-1414
  • Fax:
Mailing address:
  • Phone: 401-684-1414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number202050
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: