Individual
DONNA WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDP
Contact information
Practice address
2198 WALLUM LAKE RD., PASCOAG, RI 02859
(401) 568-5284
Mailing address
528 N MAIN ST, PROVIDENCE, RI 02904-5757
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCDP00152
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DW66813
—
RI
Enumeration date
05/23/2007
Last updated
11/27/2007
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