Individual
MARK BARRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LCDP
Contact information
Practice address
580 TEN ROD RD, NORTH KINGSTOWN, RI 02852-4220
(401) 294-6170
(401) 295-5255
Mailing address
25 CEDAR POND DR, #11, WARWICK, RI 02886-6636
(716) 207-5722
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDP00510
RI
Other
Enumeration date
01/17/2012
Last updated
01/17/2012
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