Provider Demographics
NPI:1124597570
Name:KWIATKOWSKI, JOAN (MSW)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:KWIATKOWSKI
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 CHAPMAN ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-4533
Mailing Address - Country:US
Mailing Address - Phone:401-652-4129
Mailing Address - Fax:
Practice Address - Street 1:225 CHAPMAN ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-4533
Practice Address - Country:US
Practice Address - Phone:401-652-4129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-15
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical