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Individual

TAMRA LAVOIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
455 DOUGLAS AVE, PROVIDENCE, RI 02908-2542
(401) 553-8600
Mailing address
222 GLENWOOD AVE, PAWTUCKET, RI 02860-5939
(401) 724-8299

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OT00417
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OT00417
STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS DEPARTMENT OF HEALTH
RI
Enumeration date
11/28/2012
Last updated
11/28/2012
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