Individual
MR. MARK ANTHONY HALLETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
600 COMMONWEALTH AVE, WARWICK, RI 02886
(401) 739-4241
Mailing address
419 SANDY LN, WARWICK, RI 02889-4381
(401) 339-8013
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA00645
RI
Other
Enumeration date
09/05/2013
Last updated
09/05/2013
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