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General NPI Number Information
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NPI Number | 1346048105
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Entity Type | Individual
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Provider Name | ADELE JANIK
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Gender |
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Dates
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Enumeration Date | 03/06/2025
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Last Update Date | 03/06/2025
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Provider Practice Location Address
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Address Line | 2090 WALLUM LAKE RD
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City | PASCOAG
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State | RI
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Zip | 02859-1813
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Country | US
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Telephone | 401-567-5460
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Fax |
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Provider Business Mailing Address
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Address Line | 1318 SMITH ST
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City | PROVIDENCE
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State | RI
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Zip | 02908-1820
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Country | US
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Telephone |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW03040
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License Number State | RI
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