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Individual
KIPP R LAWRENCE
Active
Individual
KIPP R LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMHC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
167
RI
101YM0800X
Mental Health Counselor
Primary
MHC00446
RI
Other
Enumeration date
02/15/2008
Last updated
04/25/2013
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