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General NPI Number Information
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NPI Number | 1194865964
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Entity Type | Organization
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Legal Business Name | SOUTHERN RI REGIONAL COLLABORATIVE
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 646 CAMP AVE
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City | NORTH KINGSTOWN
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State | RI
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Zip | 02852-4008
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Country | US
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Telephone | 401-295-2888
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Fax | 401-295-3232
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Provider Business Mailing Address
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Address Line | 646 CAMP AVE
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City | NORTH KINGSTOWN
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State | RI
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Zip | 02852-4008
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Country | US
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Telephone | 401-295-2888
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Fax | 401-295-3232
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. LIZANN R GIBSON
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Credential |
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Telephone | 401-295-2888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number |
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License Number State |
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