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THEOFANIS BABASIDIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA

Contact information

Practice address
99 BURBANK ST, CRANSTON, RI 02910-3841
(585) 354-6692
Mailing address
99 BURBANK ST, CRANSTON, RI 02910-3841

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LMHC10005000
MA
106S00000X
Behavior Technician
Primary

Other

Enumeration date
06/06/2023
Last updated
03/25/2026
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