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Individual

KELLEY MARIE FARIA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMHC

Contact information

Practice address
2699 POST RD, WARWICK, RI 02886-3075
(401) 924-5013
Mailing address
17 HENRY ST, EAST PROVIDENCE, RI 02914-4509
(401) 383-0437

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MHC00298
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
31793-1
BLUE CROSS BLUE SHIELD
RI
01
413827
BLUE CHIP
RI
Enumeration date
08/31/2006
Last updated
08/02/2007
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