Ivy Medeiros, LICSW

NPI #1831610344 in Woonsocket, Rhode Island

Provider Information

NPI Number: 1831610344
Entity Type: Individual
Name: Ivy Medeiros, LICSW
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker - Clinical
Credential: LICSW
Enumeration Date: Jul 6, 2017
Last Updated: Jul 6, 2017

Practice Location

Address: 245 MAIN ST
City: Woonsocket
State: Rhode Island
ZIP Code: 02895-3123
Phone: (401) 235-7000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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