| NPI | 1104657212 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER RYAN GIOVINO Owner 401-526-4522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| Enumeration Date | 2024-08-10 |
| Last Update Date | 2024-08-10 |