Healthcare Provider Details

I. General information

NPI: 1407967169
Provider Name (Legal Business Name): CHRISTIANNE ESPOSITO-SMYTHERS PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHRISTIANNE ESPOSITO PHD

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 VETERANS MEMORIAL PKWY
RIVERSIDE RI
02915-5061
US

IV. Provider business mailing address

BROWN UNIVERSITY CENTER FOR ALCOHOL & ADDICTION, BOX G-BH
PROVIDENCE RI
02912-0001
US

V. Phone/Fax

Practice location:
  • Phone: 401-432-1000
  • Fax: 401-432-1500
Mailing address:
  • Phone: 401-444-1898
  • Fax: 401-444-1850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS00822
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: