Individual
MICHAEL MENDOZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1226 PARK AVE # 3, WOONSOCKET, RI 02895-6533
(508) 298-1640
Mailing address
1226 PARK AVE # 3, WOONSOCKET, RI 02895-6533
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
12/23/2010
Last updated
12/23/2010
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