Individual
KAYLA MORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
530 N MAIN ST, PROVIDENCE, RI 02904-5762
(401) 585-6533
Mailing address
530 N MAIN ST, PROVIDENCE, RI 02904-5762
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDP00794
RI
Other
Enumeration date
05/20/2019
Last updated
05/20/2019
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