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Individual

ALBERT DUSSAULT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LICMHC

Contact information

Practice address
11 BELMONT ST, PAWTUCKET, RI 02860-5617
(401) 726-6650
Mailing address
11 BELMONT ST, PAWTUCKET, RI 02860-5617
(401) 726-6650

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MHC00049
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
537211000
PRACTIONER
RI
Enumeration date
01/13/2007
Last updated
07/08/2007
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