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Individual

MR. KENNETH ARNOLD WEEDEN JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
L.C.D.P. , C.C.D.P.D

Contact information

Practice address
610 WAMPANOAG TRL, EAST PROVIDENCE, RI 02915-1504
(401) 431-9870
(401) 438-1957
Mailing address
610 WAMPANOAG TRL, RIVERSIDE, RI 02915-1504
(401) 431-9870
(401) 438-1957

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDP00467
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
101YA0400X
RI DEPT. OF HEALTH
RI
05
KW31753
RI
Enumeration date
05/04/2006
Last updated
01/13/2010
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