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General NPI Number Information
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NPI Number | 1821941337
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Entity Type | Individual
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Provider Name | HALEY ELIZABETH DEGRAIDE
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Gender | Female
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Dates
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Enumeration Date | 02/16/2026
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Last Update Date | 02/16/2026
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Provider Practice Location Address
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Address Line | 18 GOODING AVE
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City | BRISTOL
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State | RI
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Zip | 02809-2610
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Country | US
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Telephone | 401-253-0002
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Fax |
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Provider Business Mailing Address
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Address Line | 26 RHODES AVE
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City | RIVERSIDE
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State | RI
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Zip | 02915-2429
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Country | US
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Telephone | 401-258-5307
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | ISW04660
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License Number State | RI
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