Individual
LISA ANN CICCONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSW, BS, BA
Contact information
Practice address
66 PAVILION AVE, PROVIDENCE, RI 02905-1522
(401) 461-9110
(401) 461-9194
Mailing address
66 PAVILION AVE, PROVIDENCE, RI 02905-1522
(401) 461-9110
(401) 461-9194
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/12/2010
Last updated
07/12/2010
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