Individual
JESUS BERRIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
530 N MAIN ST, PROVIDENCE, RI 02904-5762
(401) 276-4100
Mailing address
530 N MAIN ST, PROVIDENCE, RI 02904-5762
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDP00716
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101YA0400X
—
RI
Enumeration date
11/27/2017
Last updated
11/27/2017
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