Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | PS01547 | RI |
NPI | 1124461744 |
---|---|
Provider Name | Rebecca Newland Kilch |
First Address | Riverside, RI 02915-5061 |
Second Address | Riverside, RI 02915-5061 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2013 |
Last Update Date | 24/07/2019 |