Individual
TAYLOR RALEIGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
153 SUMMER ST, PROVIDENCE, RI 02903-4011
(401) 276-4365
Mailing address
153 SUMMER STREET, PROVIDENCE, RI 02910
(401) 276-4365
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW01713
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972662104
—
RI
Enumeration date
10/03/2014
Last updated
10/03/2014
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