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General NPI Number Information
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NPI Number | 1558347997
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Entity Type | Individual
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Provider Name | CHRISTINE LOUISE TRASK PHD, ABPP
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Gender | Female
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Dates
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Enumeration Date | 12/19/2005
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 1130 TEN ROD ROAD BLDG. E, SUITE 101
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City | NORTH KINGSTOWN
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State | RI
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Zip | 02852
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Country | US
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Telephone | 401-294-6900
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Fax | 401-294-6690
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Provider Business Mailing Address
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Address Line | 94 LAUREL RIDGE LN
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City | NORTH KINGSTOWN
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State | RI
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Zip | 02852-4147
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Country | US
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Telephone | 401-529-8049
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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 | PS00835
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | PS00835
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License Number State | RI
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