| NPI | 1306630199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN DUCHARME Credentialing/Billing Manager 401-533-6245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2025-04-07 |
| Last Update Date | 2025-04-07 |