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General NPI Number Information
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NPI Number | 1255626420
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Entity Type | Organization
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Legal Business Name | NELSON D MARTINS PHD LLC
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Dates
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Enumeration Date | 06/15/2011
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Last Update Date | 06/15/2011
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Provider Practice Location Address
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Address Line | 800 OAKLAWN AVE SUITE C204
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City | CRANSTON
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State | RI
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Zip | 02920-2822
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Country | US
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Telephone | 401-942-3300
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Fax | 401-943-5492
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Provider Business Mailing Address
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Address Line | 800 OAKLAWN AVE SUITE C204
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City | CRANSTON
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State | RI
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Zip | 02920-2822
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Country | US
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Telephone | 401-942-3300
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Fax | 401-943-5492
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Authorized Official
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Title or Position | OWNER/ PSCHOLOGIST
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Name | MR. NELSON D MARTINS
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Credential | PHD
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Telephone | 401-441-3820
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PS000337
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License Number State | RI
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