Individual
BRENDA DIANE ELINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11 KING CHARLES DR STE A2, PORTSMOUTH, RI 02871-1364
(401) 683-0857
(401) 293-0142
Mailing address
11 KING CHARLES DR STE A2, PORTSMOUTH, RI 02871-1364
(401) 683-0857
(401) 293-0142
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDP595
RI
Other
Enumeration date
10/25/2014
Last updated
10/25/2014
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