Individual
KENNETH LINDGREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
530 N MAIN ST, PROVIDENCE, RI 02904-5762
(401) 228-6614
Mailing address
530 N MAIN ST, PROVIDENCE, RI 02904-5762
(401) 228-6614
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDP00648
RI
Other
Enumeration date
06/17/2016
Last updated
06/17/2016
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