Individual
MARY BETH DZIEDZIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
530 N MAIN ST, PROVIDENCE, RI 02904-5762
(401) 274-2500
Mailing address
31 JOHN CLARKE RD, MIDDLETOWN, RI 02842-5641
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW02409
RI
Other
Enumeration date
08/16/2011
Last updated
07/18/2014
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