Individual
MRS. IVY KOLB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.I.C.S.W.
Contact information
Practice address
610 MANTON AVE, PROVIDENCE, RI 02909-5633
(401) 274-6310
(401) 421-1977
Mailing address
610 MANTON AVE, PROVIDENCE, RI 02909-5633
(401) 274-6310
(401) 421-1977
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ISW00637
RHODE ISLAND DEPARTMENT OF HEALTH
RI
Enumeration date
07/01/2015
Last updated
07/01/2015
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