Organization
NEW ENGLAND WELLNESS COLLABORATIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRYSTAL VASCONCELOS LICSW (OWNER)
(508) 812-0613
Entity
Organization
Contact information
Practice address
1 RICHMOND SQ STE 321W, PROVIDENCE, RI 02906-5156
(508) 812-0613
Mailing address
1 RICHMOND SQ STE 321W, PROVIDENCE, RI 02906-5156
(508) 812-0613
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
02/23/2019
Last updated
02/23/2019
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