Individual
ASHLEY TAVAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
230 RESERVOIR AVE, PROVIDENCE, RI 02907-3430
(401) 484-7738
Mailing address
112 PROVIDENCE ST, PROVIDENCE, RI 02907-1027
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW02360
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0614
NEIGHBORHOOD HEALTH PLAN
RI
05
—
ES01788
—
RI
01
—
SB870
BLUE CROSS
RI
Enumeration date
08/25/2015
Last updated
10/30/2019
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