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Individual

MRS. JUDITH ANNE HART

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCDP

Contact information

Practice address
610 WAMPANOAG TRAIL, EAST PROVIDENCE, RI 02915
(401) 431-9870
(401) 435-7486
Mailing address
163 SLATER PARK AVE, PAWTUCKET, RI 02861-3213
(401) 440-0472

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCDP00173
RI
101YM0800X
Mental Health Counselor
Primary
MHC00362
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
JL58361
RI
Enumeration date
08/09/2006
Last updated
05/20/2008
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