| Doctor Name: | LORETTE DUSSAULT |
| NPI Number: | 1104838978 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LICSW |
| License Number: | ISW00062 |
| Business Practice Address: | 55 S Brow St East Providence, RI - 029144433 |
| Business Phone Number: | 4014344748 |
| Business Fax Number: | |
| Mailing Address: | 528 N Main St, PROVIDENCE |
| State: | RI |
| Postal Code: | 029045757 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 08/12/2006 |
| NPI Last Update Date: | 03/27/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | ISW00062 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | RI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |