Individual
LORETTE DUSSAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW00062
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104847946
THE PROVIDENCE CENTER NPI
RI
01
—
3443-4
BLUE CROSS
RI
01
—
406328
BLUE CHIP
RI
01
—
62-19452
UNITED BEHAVIORAL HEALTH
RI
05
—
LD05243
—
RI
Enumeration date
08/12/2006
Last updated
03/27/2009
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