Doctor Name: | TANIA A ANTONIO |
NPI Number: | 1669771374 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | CSW01297 |
Business Practice Address: | 63 Harmony Hill Rd Chepachet, RI - 028141429 |
Business Phone Number: | 4019490690 |
Business Fax Number: | |
Mailing Address: | 7 Morrill Ln, Unit #3 NORTH PROVIDENCE |
State: | RI |
Postal Code: | 029044975 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/21/2011 |
NPI Last Update Date: | 03/21/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | CSW01297 |
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 |