Individual
MARYBETH O'DONNELL WAITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
1011 VETERANS MEMORIAL PKWY, EAST PROVIDENCE, RI 02915-5061
(401) 432-1284
(401) 432-1509
Mailing address
1011 VETERANS MEMORIAL PKWY, EAST PROVIDENCE, RI 02915-5061
(401) 432-1284
(401) 432-1509
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW01584
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27446-3
BLUE CROSS
RI
01
—
411706
BLUE CHIP
RI
01
—
62-70218
UNITED BEHAVIORAL HEALTH
RI
05
—
MO52565
—
RI
Enumeration date
06/22/2006
Last updated
03/23/2018
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