Organization
ANGELA RUDNER PSYCHOTHERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGELA SUSAN RUDNER LICSW (PRESIDENT)
(401) 573-9905
Entity
Organization
Contact information
Practice address
1 RICHMOND SQ, STE152 E, PROVIDENCE, RI 02906-5139
(401) 573-9905
Mailing address
2 REGENCY PLZ APT 1212, PROVIDENCE, RI 02903-3156
(410) 370-0076
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
116924
MA
1041C0700X
Clinical Social Worker
15954
MD
1041C0700X
Clinical Social Worker
Primary
ISW02235
RI
Other
Enumeration date
06/22/2016
Last updated
06/22/2016
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