Individual
TIMOTHY ALLEN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
830 CHALKSTONE AVE, PROVIDENCE, RI 02908-4734
(401) 273-7100
Mailing address
830 CHALKSTONE AVE, PROVIDENCE, RI 02908-4734
(401) 273-7100
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
RN49781
RI
Other
Enumeration date
06/21/2012
Last updated
06/21/2012
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