Individual
MR. CLYDE WILLIAM GODFREY I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.I.C.S.W.
Contact information
Practice address
52 CAPTAINS CIR, TIVERTON, RI 02878-2408
(508) 493-3399
Mailing address
PO BOX 265, TIVERTON, RI 02878-0265
(508) 493-3399
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1026910
MA
Other
Enumeration date
11/29/2014
Last updated
11/29/2014
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