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Individual

SOTANNARY IN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
55 HOPE ST, PROVIDENCE, RI 02906-2001
(401) 331-1350
(401) 277-3366
Mailing address
PO BOX 6688, C/O FAMILY SERVICE OF RI, PROVIDENCE, RI 02940-6688
(401) 331-1350
(401) 277-3366

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
CSW01349
RI

Other

Enumeration date
01/28/2011
Last updated
01/28/2011
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