Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XM0800X | Mental Health |
NPI | 1558855833 |
---|---|
Provider Name | Yolonda Marie Washburn |
First Address | Providence, RI 02904-2856 |
Second Address | Attleboro, MA 02703-2570 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2018 |
Last Update Date | 19/06/2018 |