Individual
KEVIN KRETCHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCDP, LCDS
Contact information
Practice address
1443 HARTFORD AVE, JOHNSTON, RI 02919-3224
(401) 553-1053
(401) 861-8696
Mailing address
249 ROOSEVELT AVE, SUITE 205, PAWTUCKET, RI 02860-2134
(401) 724-8400
(401) 365-1100
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDP00377
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GH57134
—
RI
Enumeration date
12/22/2008
Last updated
12/22/2008
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