Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PS01690 | RI |
Y | 103T00000X | Psychologist | PS01690 | RI |
N | 102L00000X | Psychologist | PY0377 | NV |
N | 103T00000X | Psychologist | PY0377 | NV |
NPI | 1003301987 |
---|---|
Provider Name | Dr. Kevin Farrell Gaw |
First Address | Cumberland, RI 02864-4216 |
Second Address | Cumberland, RI 02864-4216 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2018 |
Last Update Date | 25/06/2018 |