Individual
JULIO EDUARDO TAVAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
105 BACON ST, PAWTUCKET, RI 02860-5542
(401) 722-3560
Mailing address
150 RIVER AVE, PROVIDENCE, RI 02908-4732
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/04/2020
Last updated
08/04/2020
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