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Individual

DR. SAMUEL R STOCKWELL

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
30 HOLLEY ST, WAKEFIELD, RI 02879-3300
(401) 789-0963
(401) 789-9063
Mailing address
30 HOLLEY ST, WAKEFIELD, RI 02879-3300
(401) 789-0963
(401) 789-9063

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
224
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1020690
BEACON
RI
01
108714
TRICARE
RI
01
61-08837
UBH
RI
05
9009224
RI
01
9224-7
BCBS
RI
Enumeration date
06/14/2006
Last updated
07/08/2007
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