Individual
JOHN REARDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
134 THURBERS AVE, PROVIDENCE, RI 02905-4754
(401) 331-1350
(401) 277-3366
Mailing address
134 THURBERS AVE, PROVIDENCE, RI 02905-4754
(401) 331-1350
(401) 277-3366
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW02479
RI
Other
Enumeration date
10/15/2014
Last updated
10/15/2014
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