Individual
SUSAN DICKSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1011 VETERANS MEMORIAL PKWY, EAST PROVIDENCE, RI 02915-5061
(401) 793-8731
(401) 432-1500
Mailing address
1011 VETERANS MEMORIAL PKWY, EAST PROVIDENCE, RI 02915-5061
(401) 793-8731
(401) 432-1500
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS00463
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30175-2
BLUE CROSS
RI
01
—
406326
BLUE CHIP
RI
01
—
61-15830
UNITED BEHAVIORAL HEALTH
RI
05
—
SD10788
—
RI
Enumeration date
06/13/2006
Last updated
07/08/2007
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