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General NPI Number Information
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NPI Number | 1134900574
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Entity Type | Individual
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Provider Name | MARIAH DITORO
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Gender | Female
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Dates
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Enumeration Date | 10/11/2023
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Last Update Date | 10/11/2023
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Provider Practice Location Address
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Address Line | 469 CENTERVILLE RD STE 105
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City | WARWICK
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State | RI
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Zip | 02886-4356
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Country | US
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Telephone | 401-773-3700
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Fax |
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Provider Business Mailing Address
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Address Line | 21 ARROW WAY
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City | CRANSTON
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State | RI
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Zip | 02921-1903
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Country | US
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Telephone | 401-429-8565
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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