Individual
KRYSTAL VASCONCELOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
825 CHALKSTONE AVE, SOCIAL SERVICES, PROVIDENCE, RI 02908-4728
(401) 456-2000
Mailing address
825 CHALKSTONE AVE, N. CAMPUS BUSINESS OFFICE, ATTN R. SOARES, PROVIDENCE, RI 02908-4728
(401) 456-2525
(401) 456-6742
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW01448
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CSW01448
LICENSE NUMBER
RI
Enumeration date
09/16/2013
Last updated
09/16/2013
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