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Individual

MRS. AMANDA ELAINE PELLETIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
1011 VETERANS MEMORIAL PKWY, RIVERSIDE, RI 02915-5061
(401) 432-1000
(401) 432-1500
Mailing address
117 ELLENFIELD ST STE 101, PROVIDENCE, RI 02905-4513
(401) 444-6779
(401) 444-6912

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
113201
MA
1041C0700X
Clinical Social Worker
Primary
ISW01691
RI

Other

Enumeration date
02/05/2007
Last updated
11/13/2017
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