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General NPI Number Information
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NPI Number | 1891938791
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Entity Type | Organization
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Legal Business Name | CORDIS COUNSELING
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Dates
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Enumeration Date | 04/08/2009
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Last Update Date | 04/08/2009
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Provider Practice Location Address
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Address Line | 750 EAST AVENUE
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City | PAWTUCKET
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State | RI
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Zip | 02860-6165
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Country | US
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Telephone | 401-663-9534
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Fax |
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Provider Business Mailing Address
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Address Line | 750 EAST AVENUE
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City | PAWTUCKET
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State | RI
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Zip | 02860-6165
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Country | US
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Telephone | 401-663-9534
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Fax |
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Authorized Official
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Title or Position | MARRIAGE AND FAMILY THERAPIST
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Name | MRS. CARA C QUINN
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Credential | LMFT
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Telephone | 401-663-9534
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT00118
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License Number State | RI
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