Individual
MRS. MARY LOUISE TAFT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Contact information
Practice address
11 KING CHARLES DR, SUITE A4A, PORTSMOUTH, RI 02871-1364
(401) 683-0920
Mailing address
PO BOX 811, PORTSMOUTH, RI 02871-0811
(401) 683-0920
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW00068
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7425-2
BLUE CROSS PROVIDER NUMBE
RI
01
—
ROO2362
TRICARE
RI
Enumeration date
09/24/2006
Last updated
07/08/2007
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