Individual
DEIRDRE T BROGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1011 VETERANS MEMORIAL PKWY, RIVERSIDE, RI 02915-5061
(401) 432-1532
(401) 432-1500
Mailing address
1011 VETERANS MEMORIAL PKWY, RIVERSIDE, RI 02915-5061
(401) 432-1284
(401) 432-1509
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PS01263
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PS01263
PROFESSIONAL LICENSE
RI
Enumeration date
10/30/2009
Last updated
03/06/2012
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