Individual
JENNIFER MARIE PRIMACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
345 BLACKSTONE BLVD, DEPARTMENT OF PSYCHOSOCIAL RESEARCH, PROVIDENCE, RI 02906-4800
(401) 455-6336
Mailing address
345 BLACKSTONE BLVD, DEPARTMENT OF PSYCHOSOCIAL RESEARCH, PROVIDENCE, RI 02906-4800
(401) 455-6336
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
PS01130
RI
103TC0700X
Clinical Psychologist
Primary
PS01130
RI
Other
Enumeration date
03/04/2011
Last updated
03/04/2011
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