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Individual

MELISSA ANNE BUTTARO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
1 HOPPIN ST, SUITE 317, PROVIDENCE, RI 02903-4141
(401) 793-8740
(401) 444-7865
Mailing address
593 EDDY ST, APC 978, PROVIDENCE, RI 02903-4923
(401) 444-4318
(401) 444-7865

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
PS01131
RI
103T00000X
Psychologist
Primary
PS01131
RI
103TC2200X
Clinical Child & Adolescent Psychologist
PS01131
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PS01131
RI PROFESSIONAL LICENSE
RI
Enumeration date
06/29/2009
Last updated
06/18/2014
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