Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) |
NPI | 1003448879 |
---|---|
Provider Name | Miss Ashley L Addison |
First Address | Providence, RI 02907-3737 |
Second Address | Providence, RI 02904-5762 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2020 |
Last Update Date | 10/02/2020 |