Individual
JANIS MARIE DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
42 VALLEY RD, MIDDLETOWN, RI 02842-6400
(401) 431-9870
Mailing address
70 MUSSEL BED SHOAL RD, PORTSMOUTH, RI 02871-2012
(401) 662-7351
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MHC 00265
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29911-2
BLUE CROSS
RI
01
—
412885
BLUE CHIP
RI
05
—
JK52562
—
RI
Enumeration date
12/12/2005
Last updated
02/19/2020
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