Individual
JEFFREY P MIGNEAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
347 BROADWAY, PROVIDENCE, RI 02909-1101
(401) 270-9808
(401) 270-9808
Mailing address
347 BROADWAY, PROVIDENCE, RI 02909-1101
(401) 270-9808
(401) 270-9808
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS00585
RI
Other
Enumeration date
01/08/2007
Last updated
10/21/2011
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