Individual
CLARA PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
520 HOPE STREET, THE PROVIDENCE CENTER, PROVIDENCE, RI 02906
(401) 276-4155
Mailing address
528 NORTH MAIN STREET, THE PROVIDENCE CENTER, PROVIDENCE, RI 02904
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
CSW00745
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104847946
THE PROVIDENCE CENTER NPI
RI
05
—
CP44492
—
RI
Enumeration date
04/09/2008
Last updated
07/25/2008
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