Individual
MADELINE KALLMYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
530 N MAIN ST, PROVIDENCE, RI 02904-5762
(443) 717-1692
Mailing address
22 WALL ST UNIT 24B, BRISTOL, RI 02809-3615
(443) 717-1692
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
10/21/2019
Last updated
06/25/2025
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