Individual
MR. JAIME MENDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
830 CHALKSTONE AVE, TRAILER 36, PROVIDENCE, RI 02908-4734
(401) 640-3917
(401) 525-2557
Mailing address
24 ANNETTE AVE, PAWTUCKET, RI 02861-4418
(401) 640-3917
(401) 525-2557
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW02030
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
JM66771
—
RI
Enumeration date
05/17/2007
Last updated
10/31/2016
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