Individual
SHANNON MARIE ERISMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
345 BLACKSTONE BLVD, PROVIDENCE, RI 02906-4800
(401) 455-6351
(401) 455-6698
Mailing address
502 BULLOCKS POINT AVE, RIVERSIDE, RI 02915-3504
(401) 626-4823
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS01283
RI
Other
Enumeration date
05/29/2012
Last updated
10/11/2023
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