Individual
KYLE FERNANDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
1087 WARWICK AVE, WARWICK, RI 02888-3545
(401) 383-2200
Mailing address
1087 WARWICK AVE, WARWICK, RI 02888-3545
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
05/24/2021
Last updated
05/24/2021
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