| Doctor Name: | CHANTA POU |
| NPI Number: | 1023350485 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | NPP37746 |
| Business Practice Address: | 68 Cumberland St Ste 102 Woonsocket, RI - 028953300 |
| Business Phone Number: | 4013561940 |
| Business Fax Number: | |
| Mailing Address: | 68 Cumberland St, Ste 102 WOONSOCKET |
| State: | RI |
| Postal Code: | 028953300 |
| Phone Number: | 4013561940 |
| Fax Number: | |
| NPI Enumeration Date: | 03/25/2013 |
| NPI Last Update Date: | 06/11/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | NPP37746 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | RI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |