Individual
MORGAN MCGILLICUDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
830 CHALKSTONE AVE, PROVIDENCE, RI 02908-4734
(401) 273-7100
Mailing address
830 CHALKSTONE AVE, PROVIDENCE, RI 02908-4734
(401) 273-7100
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS01578
RI
Other
Enumeration date
08/19/2016
Last updated
08/19/2016
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