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General NPI Number Information
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NPI Number | 1417130907
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Entity Type | Organization
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Legal Business Name | RONDEAU PSYCHOTHERAPY
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Dates
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Enumeration Date | 12/07/2007
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Last Update Date | 12/07/2007
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Provider Practice Location Address
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Address Line | 2 RAINONE CT
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City | COVENTRY
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State | RI
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Zip | 02816-8728
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Country | US
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Telephone | 401-499-5366
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Fax |
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Provider Business Mailing Address
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Address Line | 2 RAINONE CT
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City | COVENTRY
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State | RI
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Zip | 02816-8728
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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 | OWNER / CLINCAL DIRECTOR
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Name | MELISSA RONDEAU
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Credential |
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Telephone | 401-499-5366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 00223
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License Number State | RI
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