Individual
MRS. KELLY MARTINS DESOUSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
830 CHALKSTONE AVE, PROVIDENCE, RI 02908-4734
(401) 273-7100
Mailing address
591 DICKINSON ST, FALL RIVER, MA 02721-4547
(508) 567-4672
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
215696
MA
Other
Enumeration date
10/16/2009
Last updated
10/16/2009
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