Individual
MS. MARY R DILIBERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PCNS
Contact information
Practice address
400 BALD HILL RD, SUITE 510, WARWICK, RI 02886
(401) 732-3637
(701) 732-2875
Mailing address
PO BOX 174, FOSTER, RI 02825
(401) 359-5130
(401) 397-6428
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
001427
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4169406
—
CT
Enumeration date
05/10/2006
Last updated
09/24/2013
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