Individual
ILEANA SANTIAGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1052 PARK AVE, CRANSTON, RI 02910-3225
(401) 461-5056
Mailing address
1052 PARK AVE, CRANSTON, RI 02910-3225
(401) 461-5056
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDP00575
RI
Other
Enumeration date
01/09/2015
Last updated
01/09/2015
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