Individual
MARCIA LISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1351 S COUNTY TRL, BUILDING 2 SUITE 210, EAST GREENWICH, RI 02818-5079
(401) 884-2088
(401) 884-2075
Mailing address
1351 S COUNTY TRL, BUILDING 2 SUITE 210, EAST GREENWICH, RI 02818-5079
(401) 884-2088
(401) 884-2075
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS00692
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30027-8
BLUE CROSS BLUE SHIELD
RI
01
—
COORDINATED HEALTH P
407788
RI
Enumeration date
07/05/2006
Last updated
07/08/2007
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