Organization
WILD TAINO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KOREN CARBUCCIA CPD (OWNER)
(401) 290-8076
Entity
Organization
Contact information
Practice address
1578 MAIN ST # A, WEST WARWICK, RI 02893-4055
(401) 290-8076
Mailing address
1578 MAIN ST # A, WEST WARWICK, RI 02893-4055
(401) 290-8076
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
—
—
Other
Enumeration date
12/15/2022
Last updated
12/15/2022
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