Individual
SAMANTHA ROSE KAVANAGH, LICSW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
501 WAMPANOAG TRL UNIT 400, RIVERSIDE, RI 02915-1507
(401) 785-0040
Mailing address
4800 N SCOTTSDALE RD STE 2500, SCOTTSDALE, AZ 85251-7630
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW04045
RI
Other
Enumeration date
02/15/2024
Last updated
08/29/2024
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