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General NPI Number Information
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NPI Number | 1649429747
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Entity Type | Individual
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Provider Name | MICHELLE MCCOMBE LICSW
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Gender | Female
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Dates
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Enumeration Date | 09/12/2008
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Last Update Date | 02/24/2010
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Provider Practice Location Address
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Address Line | 76 HAMMERLUND WAY TECH 3
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City | MIDDLETOWN
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State | RI
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Zip | 02842-5640
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Country | US
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Telephone | 401-207-5733
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Fax | 401-845-8933
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Provider Business Mailing Address
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Address Line | 31 JOHN CLARKE ROAD
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City | MIDDLETOWN
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State | RI
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Zip | 02842-5641
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Country | US
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Telephone | 401-207-5733
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Fax | 401-845-8933
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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 | ISW01985
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License Number State | RI
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