Individual
JOHN NEUBAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
52 ELMCREST AVE, PROVIDENCE, RI 02908-1808
(516) 637-4963
Mailing address
52 ELMCREST AVE, PROVIDENCE, RI 02908-1808
(516) 637-4963
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW02108
RI
Other
Enumeration date
08/11/2011
Last updated
08/11/2011
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