Organization
OPAL BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSANNA DRAIGHAN APRN (OWNER)
(401) 217-9377
Entity
Organization
Contact information
Practice address
383 W FOUNTAIN ST STE 103, PROVIDENCE, RI 02903-3515
(401) 217-9377
(401) 200-3166
Mailing address
3 RINGGOLD ST, PROVIDENCE, RI 02903-1432
(401) 217-9377
(401) 200-3166
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APRN01685
BOARD OF NURSING
RI
01
—
RN2327944
BOARD OF NURSING
MA
Enumeration date
02/14/2023
Last updated
04/05/2023
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