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Individual

MICHELLE MACKIE HERVIEUX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1992 OLD LOUISQUISSET PIKE, LINCOLN, RI 02865-4590
(401) 475-0653
Mailing address
825 PONTIAC AVE APT 18301, CRANSTON, RI 02910-5900
(401) 533-3409

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
CSW0254
RI

Other

Enumeration date
08/11/2021
Last updated
08/11/2021
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