Organization
PEACEFUL MIND, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CECILIA M DIETZLER LICSW (OWNER)
(401) 273-2858
Entity
Organization
Contact information
Practice address
120 WAYLAND AVE, PROVIDENCE, RI 02906-4318
(401) 273-2858
(843) 667-6687
Mailing address
120 WAYLAND AVE, PROVIDENCE, RI 02906-4318
(401) 273-2858
(843) 667-6687
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW00899
RI
Other
Enumeration date
06/02/2010
Last updated
06/02/2010
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