Individual
JESSICA FAY RAINEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW01749
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000031210
RI BLUE CROSS PROVIDER #
RI
01
—
413318
RI BLUE CHIP PROVIDER #
RI
Enumeration date
05/11/2007
Last updated
07/08/2007
Update your record
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