Individual
JORGE CEVALLOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MASTERS
Contact information
Practice address
160 BEECHWOOD AVE, PAWTUCKET, RI 02860-5402
(401) 722-5573
(401) 724-9735
Mailing address
160 BEECHWOOD AVE, PAWTUCKET, RI 02860-5402
(401) 722-5573
(401) 724-9735
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GH57134
—
RI
Enumeration date
09/03/2008
Last updated
09/03/2008
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