Organization
CENTER FOR DYNAMIC AND BEHAVIORAL THERAPY LLC
Active
Other names
PVD Psychological Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICOLE ISSA PSYD (OWNER)
(401) 330-5882
Entity
Organization
Contact information
Practice address
382 THAYER ST, PROVIDENCE, RI 02906-1558
(401) 330-5882
(401) 226-0137
Mailing address
11 S ANGELL ST # 405, PROVIDENCE, RI 02906-5206
(401) 330-5882
(401) 226-0137
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
PS01615
RI
103TC0700X
Clinical Psychologist
Primary
PS01616
RI
Other
Enumeration date
07/11/2017
Last updated
07/25/2021
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