Individual
TAVIT KENNETH SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
6899 POST RD, STE 2E, NORTH KINGSTOWN, RI 02852
(401) 398-0109
Mailing address
52 WOODBINE RD, WAKEFIELD, RI 02879
(401) 398-0109
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW01633
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TS54767
—
RI
Enumeration date
07/07/2006
Last updated
07/08/2007
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