Individual
ROBERT FIDALGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
166 VALLEY ST, APT 6M310, PROVIDENCE, RI 02909-2400
(646) 243-8916
Mailing address
166 VALLEY ST, APT 6M310, PROVIDENCE, RI 02909-2400
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT01169
RI
Other
Enumeration date
02/07/2012
Last updated
02/07/2012
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