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General NPI Number Information
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NPI Number | 1649989799
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Entity Type | Individual
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Provider Name | JEFFREY DANIEL HIRSCH
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Gender | Male
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Dates
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Enumeration Date | 11/17/2022
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Last Update Date | 11/17/2022
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Provider Practice Location Address
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Address Line | 640 GEORGE WASHINGTON HIGHWAY BLDG B SUITE 103
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City | LINCOLN
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State | RI
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Zip | 02865
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Country | US
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Telephone | 401-286-1917
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Fax | 866-899-3402
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Provider Business Mailing Address
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Address Line | 6 SNOWBERRY CT
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City | SMITHFIELD
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State | RI
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Zip | 02917-4000
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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 | ISW03684
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License Number State | RI
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