Individual
MR. MARCEL A TRISVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCDP
Contact information
Practice address
CODAC PROVIDENCE, 349 HUNTINGTON AVE, PROVIDENCE, RI 02909
(401) 942-1450
Mailing address
31 NELLIE ST, PROVIDENCE, RI 02904
(401) 270-0000
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCDP-352
RI
Other
Enumeration date
05/01/2007
Last updated
07/08/2007
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