Individual
MRS. STACEY LYNN DEORSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
830 CHALKSTONE AVE, VAMC, PROVIDENCE, RI 02908-4799
(401) 273-7100
Mailing address
830 CHALKSTONE AVE, VAMC, PROVIDENCE, RI 02908-4799
(401) 273-7100
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
CSW0116
RI
Other
Enumeration date
10/17/2007
Last updated
10/17/2007
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