Individual
DR. JUSTIN VANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
830 CHALKSTONE AVE, ROOM 368, PROVIDENCE, RI 02908-4734
(401) 273-7100
Mailing address
35 GROVE ST, APARTMENT B, PAWTUCKET, RI 02860-3202
(913) 424-3185
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
R0196
MO
103TC0700X
Clinical Psychologist
Primary
R0196
MO
Other
Enumeration date
03/09/2006
Last updated
09/20/2012
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