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General NPI Number Information
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NPI Number | 1265250682
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Entity Type | Organization
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Legal Business Name | INNER BALANCE OF RI
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Dates
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Enumeration Date | 10/03/2024
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 66 MAIN ST STE 202
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City | SOUTH KINGSTOWN
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State | RI
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Zip | 02879-3651
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Country | US
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Telephone | 401-251-0024
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Fax | 401-466-4027
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Provider Business Mailing Address
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Address Line | 18 E GREENWICH AVE APT 2
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City | WEST WARWICK
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State | RI
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Zip | 02893-5458
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Country | US
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Telephone | 401-241-5660
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANDRIA DUARTE
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Credential | PMHNP-BC
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Telephone | 401-241-5660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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