Individual
BRENDA LARRIVEE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
721 RESERVOIR AVE, CRANSTON, RI 02910-4430
(401) 946-4250
(401) 275-5645
Mailing address
721 RESERVOIR AVE, CRANSTON, RI 02910-4430
(401) 946-4250
(401) 275-5645
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT01692
RI
225100000X
Physical Therapist
PT11336
CA
225100000X
Physical Therapist
PT9234
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410523
BLUECHIP RI IND. ID #
RI
Enumeration date
05/16/2006
Last updated
07/08/2007
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