Individual
KRISTEN WICANDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
400 RESERVOIR AVE STE 2C, PROVIDENCE, RI 02907-3595
(401) 203-3068
Mailing address
519 PLEASANT VALLEY PKWY APT 2, PROVIDENCE, RI 02908-4211
(401) 203-3068
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MHC01703
RI
Other
Enumeration date
09/10/2020
Last updated
09/11/2024
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