Individual
HALEY MOULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-8805
Mailing address
593 EDDY ST, PROVIDENCE, RI 02903-4923
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD19966
RI
390200000X
Student in an Organized Health Care Education/Training Program
LP05374
RI
Other
Enumeration date
06/09/2021
Last updated
08/15/2024
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