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Individual

BETTY MONGEAU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
75 SOCKANOSSET CROSSROAD, CRANSTON, RI 02920
(401) 785-0371
Mailing address
75 SOCKANOSSET CROSS RD, SUITE 208B, CRANSTON, RI 02920-5558
(401) 559-5537
(401) 615-5172

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW01666
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
ISW01666
SOCIAL WORK LICENSE
RI
Enumeration date
01/23/2008
Last updated
01/23/2008
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