Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
Y | 101YM0800X | Mental Health Counselor | MHC00076 | RI |
NPI | 1003967449 |
---|---|
Provider Name | Ms. Judith H. Clarke-Jones |
First Address | Wakefield, RI 02879-2467 |
Second Address | North Kingstown, RI 02852-4161 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2007 |
Last Update Date | 12/12/2011 |