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Individual

ANASTACIA Y. KUDINOVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1 HOPPIN ST, PROVIDENCE, RI 02903-4141
(401) 444-8945
(401) 444-8742
Mailing address
117 ELLENFIELD ST STE 101, PROVIDENCE, RI 02905-4541

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
PS02153
RI
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PS02153
RI

Other

Enumeration date
05/24/2024
Last updated
06/14/2024
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