Individual
JENNIFER KRISTEN DEMELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
EDUCATOR
Contact information
Practice address
1000 EDDY ST, PROVIDENCE, RI 02905-4739
(401) 533-9100
Mailing address
1000 EDDY ST, PROVIDENCE, RI 02905-4739
(401) 533-9100
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6400144
UNITED
RI
Enumeration date
04/23/2010
Last updated
04/23/2010
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