Organization
EMPOWERED LEGACY CENTER
Active
Other names
None
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK LUDERS PAUL LICSW (THERAPIST)
(401) 263-0778
Entity
Organization
Contact information
Practice address
1200 HARTFORD AVE STE 3B, JOHNSTON, RI 02919-7143
(401) 263-0778
Mailing address
1200 HARTFORD AVE STE 3B, JOHNSTON, RI 02919-7143
(401) 263-0778
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
11/19/2024
Last updated
12/06/2024
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