Individual
LISA ANDRADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
3 CALISTO DR, REHOBOTH, MA 02769-2233
(401) 323-3781
Mailing address
3 CALISTO DR, REHOBOTH, MA 02769-2233
(401) 323-3781
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
11535
MA
103TC0700X
Clinical Psychologist
PS01812
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1309161
—
MA
Enumeration date
09/13/2011
Last updated
07/20/2022
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