Individual
SAMANTHA PHIPPS-MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDP
Contact information
Practice address
530 N MAIN ST, PROVIDENCE, RI 02904-5762
(401) 453-7618
(401) 453-7692
Mailing address
27 GEORGE ST, NORTH PROVIDENCE, RI 02911-1612
(401) 215-5584
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDP00823
RI
Other
Enumeration date
12/02/2019
Last updated
12/02/2019
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