Individual
DR. LISA FAILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2 VILLAGE GRN N APT C, RIVERSIDE, RI 02915-3944
(401) 481-1914
Mailing address
2 VILLAGE GRN N APT C, RIVERSIDE, RI 02915-3944
(401) 481-1914
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS 01036
RI
103TF0200X
Forensic Psychologist
PS 01036
RI
Other
Enumeration date
12/12/2007
Last updated
12/12/2007
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