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General NPI Number Information
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NPI Number | 1902084379
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Entity Type | Organization
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Legal Business Name | MONA R. BARBERA, PH.D.
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Dates
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Enumeration Date | 02/07/2008
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Last Update Date | 02/07/2008
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Provider Practice Location Address
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Address Line | 341 BROADWAY
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City | PROVIDENCE
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State | RI
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Zip | 02909-1143
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Country | US
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Telephone | 401-272-2029
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Fax | 866-575-1707
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Provider Business Mailing Address
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Address Line | 341 BROADWAY
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City | PROVIDENCE
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State | RI
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Zip | 02909-1143
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Country | US
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Telephone | 401-272-2029
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Fax | 866-575-1707
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Authorized Official
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Title or Position | PRESIDENT
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Name | MONA R. BARBERA
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Credential | PH.D.
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Telephone | 401-272-2029
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TP0814X
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Taxonomy Name | Psychoanalysis Psychologist
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License Number | PS00735
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License Number State | RI
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