Individual
KELSEY THERESA DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LCDP
Contact information
Practice address
530 N MAIN ST, PROVIDENCE, RI 02904-5762
(781) 812-5163
Mailing address
57 CHARLTON AVE, PAWTUCKET, RI 02860-6233
(781) 812-5163
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDP00814
RI
Other
Enumeration date
09/12/2019
Last updated
09/12/2019
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