Individual
SUSAN BRUCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
10 ELMGROVE AVE, PROVIDENCE, RI 02906-4124
(401) 489-3635
Mailing address
69 11TH ST, PROVIDENCE, RI 02906-2911
(401) 595-0657
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW01828
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659316982
BLUE CHIP
RI
05
—
SO58191
—
RI
Enumeration date
06/19/2006
Last updated
10/13/2021
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