Healthcare Provider Details
I. General information
NPI: 1619975802
Provider Name (Legal Business Name): LISA MARIE FRAPPIER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/12/2005
Last Update Date: 05/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
250 WAMPANOAG TRL SUITE 202
RIVERSIDE RI
02915
US
IV. Provider business mailing address
250 WAMPANOAG TRL SUITE 202
RIVERSIDE RI
02915-2218
US
V. Phone/Fax
- Phone: 401-435-0044
- Fax: 844-278-9690
- Phone: 401-435-0044
- Fax: 401-276-3939
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | DO 0429 |
| License Number State | RI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: