Individual
TINA KANACZET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
1 S POND DR, COVENTRY, RI 02816-7970
(401) 862-4289
Mailing address
1 S POND DR, COVENTRY, RI 02816-7970
(401) 862-4289
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP00691
RI
Other
Enumeration date
05/03/2017
Last updated
05/03/2017
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