Individual
DOREEN MARIE KENWORTHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
215 TOLL GATE RD STE 205, WARWICK, RI 02886-4461
(401) 732-0999
Mailing address
3 TOWLE DR, HOLDEN, MA 01520-1266
(508) 887-3357
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
00741
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA 00741
RI PTA LICENSE # 00741
RI
Enumeration date
12/03/2008
Last updated
12/03/2008
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