Provider Demographics
NPI:1780942292
Name:PRUNIER, MARGARET A
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:A
Last Name:PRUNIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 E GREENWICH AVE
Mailing Address - Street 2:BLDG.3 -#403
Mailing Address - City:WEST WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02893-2367
Mailing Address - Country:US
Mailing Address - Phone:508-713-8711
Mailing Address - Fax:
Practice Address - Street 1:650 E GREENWICH AVE
Practice Address - Street 2:BLDG.3 -#403
Practice Address - City:WEST WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02893-2367
Practice Address - Country:US
Practice Address - Phone:508-713-8711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-03
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
RI101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor