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Individual

STEPHANIE GONCALVES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
66 PAVILION AVE, PROVIDENCE, RI 02905-1522
(401) 461-9110
(401) 461-9194
Mailing address
66 PAVILION AVE, PROVIDENCE, RI 02905-1522
(401) 461-9110
(401) 461-9194

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
05/19/2020
Last updated
05/19/2020
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