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General NPI Number Information
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NPI Number | 1912707928
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Entity Type | Individual
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Provider Name | DHIRA PATEL PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 03/18/2025
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 345 BLACKSTONE BLVD STE 1
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City | PROVIDENCE
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State | RI
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Zip | 02906-4800
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Country | US
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Telephone | 401-455-6402
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Fax | 401-455-6405
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Provider Business Mailing Address
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Address Line | 445 TOLL GATE RD PRC AND CREDENTIALING
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City | WARWICK
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State | RI
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Zip | 02886-2759
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Country | US
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Telephone | 401-273-0641
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Fax | 401-273-2919
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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 | PSY10001067
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS02339
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License Number State | RI
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Taxonomy #3
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | PS02339
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License Number State | RI
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