Individual
JANE ELIZABETH CANCILLIERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1011 VETERANS MEMORIAL PKWY, RIVERSIDE, RI 02915-5061
(401) 432-1000
(401) 432-1500
Mailing address
593 EDDY ST, POTTER 3, PROVIDENCE, RI 02903-4923
(401) 444-4318
(401) 444-6573
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT01333
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT01333
PROFESSIONAL LICENSE
RI
Enumeration date
10/19/2012
Last updated
10/19/2012
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