Provider Information for 1649243981
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Ms. KATHRYN B EDEN MSW LICSW
Sex: Female
NPI: 1649243981
Last Updated: 2008-10-07
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||||||||||
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| NPI | 1649243981 | ||||||||||||||||||||
| Enumeration Date | 2006-02-08 | ||||||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||||||
| Status | Active | ||||||||||||||||||||
| Mailing Address | 610 WAMPANOAG TRL RIVERSIDE, RI 02915-1504 United States Phone: 401-435-7482 | Fax: | ||||||||||||||||||||
| Primary Practice Address | 610 WAMPANOAG TRAIL EAST BAY MENTAL HEALTH CENTER EAST PROVIDENCE, RI 02915 United States Phone: 401-431-9870 | Fax:401-435-7486 | ||||||||||||||||||||
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