Individual
SAMANTHA GAUVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
382 THAYER ST, PROVIDENCE, RI 02906-1558
(401) 330-5882
Mailing address
382 THAYER ST, PROVIDENCE, RI 02906-1558
(401) 330-5882
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS02030
RI
390200000X
Student in an Organized Health Care Education/Training Program
—
OH
Other
Enumeration date
02/12/2018
Last updated
12/03/2021
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