Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PS00990 | RI |
Y | 103TC0700X | Clinical Psychologist | PS00990 | RI |
NPI | 1003900085 |
---|---|
Provider Name | Dr. Vanitha G Nair |
First Address | Woonsocket, RI 02895 |
Second Address | Woonsocket, RI 02895-3323 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 29/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1028940 | BEACON (NHP) (01) | RI |
32047-2 | BLUE CROSS BLUE SHIELD (01) | RI |
413899 | BLUE CHIP (01) | RI |
VN64024 | (05) | RI |