| NPI | 1578921185 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA VICTORIA FORTUNATO Clinical Psychologist 401-489-3636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: RI PS00986) |
| Enumeration Date | 2016-02-10 |
| Last Update Date | 2016-02-10 |