Individual
LORA SPALT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDS
Contact information
Practice address
208 GOVERNOR ST, PROVIDENCE, RI 02906-3246
(401) 490-3563
(401) 490-3569
Mailing address
208 GOVERNOR ST, PROVIDENCE, RI 02906-3246
(401) 490-3563
(401) 490-3569
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCDS00047
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LS18866
—
RI
Enumeration date
10/16/2006
Last updated
07/08/2007
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