Individual
JENNIFER M ETUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1 RANDALL SQ, PROVIDENCE, RI 02904-2709
(401) 274-6339
(401) 453-6290
Mailing address
375 ALLENS AVE, PROVIDENCE, RI 02905-5010
(401) 444-0400
(401) 444-0468
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW02015
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1021740
NHP/BEACON GROUP
—
05
—
JE72997
—
RI
Enumeration date
10/03/2008
Last updated
12/15/2023
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