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Individual

KELLY TABER CHASSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW

Contact information

Practice address
1011 VETERANS MEMORIAL PKWY, EAST PROVIDENCE, RI 02915-5061
(401) 432-1602
(401) 432-1500
Mailing address
1011 VETERANS MEMORIAL PKWY, EAST PROVIDENCE, RI 02915-5061
(401) 432-1284
(401) 432-1509

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW01268
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
29522-6
BLUE CROSS
RI
01
412571
BLUE CHIP
RI
05
KC55623
RI
Enumeration date
06/22/2006
Last updated
01/06/2011
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