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Individual

DR. LISA A UEBELACKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
345 BLACKSTONE BLVD, PROVIDENCE, RI 02906-4800
(401) 455-6381
(401) 455-6235
Mailing address
345 BLACKSTONE BLVD, PROVIDENCE, RI 02906-4800
(401) 455-6381
(401) 455-6235

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS00816
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
27175-2
BLUE CROSS
RI
01
411369
BLUE CHIP
RI
01
61-49694
UBH
RI
Enumeration date
10/02/2006
Last updated
07/08/2007
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