Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003168782 |
---|---|
Provider Name | Olivia Meunier |
First Address | Providence, RI 02904-5757 |
Second Address | Providence, RI 02904-5762 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2012 |
Last Update Date | 05/10/2012 |