Individual
MANIVONE THIKEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
55 JOHN A CUMMINGS WAY, WOONSOCKET, RI 02895-3247
(401) 235-7000
Mailing address
133 POCASSET AVE, PROVIDENCE, RI 02909-4503
(401) 944-3092
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
213
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
213
PRINCIPAL COUNSELOR
RI
Enumeration date
06/25/2007
Last updated
04/01/2009
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