Individual
CAROL PELOQUIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1516 ATWOOD AVE, JOHNSTON, RI 02919-3223
(401) 553-1000
(401) 553-1046
Mailing address
1516 ATWOOD AVE, JOHNSTON, RI 02919-3223
(401) 553-1000
(401) 553-1046
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
LICSW125588
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GH57134
—
RI
Enumeration date
07/23/2012
Last updated
12/07/2023
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