Individual
MRS. ALICIA RAE TAVARES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
1093 ELMWOOD AVE APT 2, PROVIDENCE, RI 02907-3669
(401) 787-1265
Mailing address
1093 ELMWOOD AVE APT 2, PROVIDENCE, RI 02907-3669
(401) 787-1265
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MHC00856
RI
Other
Enumeration date
06/03/2014
Last updated
08/30/2024
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