Individual
MR. IGNATIUS A SAMUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1007 N MAIN ST, DAYVILLE, CT 06241-2170
(860) 774-2020
(860) 774-0095
Mailing address
157 DOVER ST, PROVIDENCE, RI 02908-3931
(401) 274-0881
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW00579
RI
Other
Enumeration date
04/23/2009
Last updated
04/23/2009
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