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General NPI Number Information
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NPI Number | 1619590726
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Entity Type | Individual
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Provider Name | AMANDA S. PHILLIPS PH.D.
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Gender | Female
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Dates
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Enumeration Date | 05/22/2020
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 146 W RIVER ST STE 11B
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City | PROVIDENCE
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State | RI
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Zip | 02904-2609
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Country | US
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Telephone | 401-606-0606
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Fax |
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Provider Business Mailing Address
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Address Line | 146 W RIVER ST STE 11B
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City | PROVIDENCE
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State | RI
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Zip | 02904-2609
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Country | US
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Telephone | 401-606-0606
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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 | 103TH0004X
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Taxonomy Name | Health Psychologist
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License Number | PS02078
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS02078
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License Number State | RI
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