Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | RI |
NPI | 1003268517 |
---|---|
Provider Name | Alisha Choquette |
First Address | Providence, RI 02907-2527 |
Second Address | Providence, RI 02907-2527 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2016 |
Last Update Date | 08/07/2016 |