Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | PS00889 | RI |
NPI | 1053324483 |
---|---|
Provider Name | Dr. John Elliott Mcgeary |
First Address | Providence, RI 02908-4734 |
Second Address | Providence, RI 02908-4734 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2006 |
Last Update Date | 15/04/2008 |