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6 Blackstone Valley Pl Suite 109 Lincoln RI 02865-1179 | |
| (401) 334-9104 | |
| (401) 334-9105 |
| Full Name | |
|---|---|
| Speciality | Psychologist |
| Location | 6 Blackstone Valley Pl, Lincoln, Rhode Island |
| Authorized Official Name and Position | Sandra E. Duclos (PRESIDENT) |
| Authorized Official Contact | 4013349104 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
6 Blackstone Valley Pl Suite 109 Lincoln RI 02865-1179 Ph: (401) 334-9104 | 6 Blackstone Valley Pl Suite 109 Lincoln RI 02865-1179 Ph: (401) 334-9104 |
| NPI Number | 1497788541 |
|---|---|
| Provider Enumeration Date | 07/09/2006 |
| Last Update Date | 10/15/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497788541 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PS00498 (Rhode Island) | Primary |
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