Individual
DAVID J. DECOSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCDP
Contact information
Practice address
105 FIR AVE, TIVERTON, RI 02878-1640
(401) 297-9090
Mailing address
105 FIR AVE, TIVERTON, RI 02878-1640
(401) 297-9090
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDP00785
RI
Other
Enumeration date
04/24/2019
Last updated
08/11/2024
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