Individual
JACKSON MELNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
394 ANGELL ST, PROVIDENCE, RI 02906-4075
(970) 596-3194
Mailing address
116 RICE AVE, EAST PROVIDENCE, RI 02914-1836
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
05/26/2021
Last updated
02/26/2026
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