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General NPI Number Information
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NPI Number | 1265864045
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Entity Type | Individual
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Provider Name | MELANY CARYN TROMBA PSYD
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Gender | Female
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Dates
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Enumeration Date | 08/05/2013
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Last Update Date | 04/16/2018
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Provider Practice Location Address
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Address Line | 1524 ATWOOD AVE SUITE 222
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City | JOHNSTON
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State | RI
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Zip | 02919-3228
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Country | US
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Telephone | 401-751-5880
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Fax |
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Provider Business Mailing Address
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Address Line | 90 DOANE ST
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City | CRANSTON
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State | RI
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Zip | 02910-2419
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Country | US
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Telephone | 239-560-5281
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS01133
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License Number State | RI
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