Individual
MR. BRIAN PALLISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
205 HALLENE RD UNIT 102, WARWICK, RI 02886-2451
(401) 426-9876
Mailing address
74 MIANTONOMO DR, WARWICK, RI 02888-5316
(401) 426-9876
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDP00783
RI
Other
Enumeration date
03/12/2019
Last updated
03/12/2019
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