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Individual

CHONLADA JARUKITISAKUL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
450 BROOK STREET, PROVIDENCE, RI 02906
(401) 863-3476
Mailing address
69 BROWN STREET BOX 1960, PROVIDENCE, RI 02912-0001

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
11069-PY-PR
MA
103T00000X
Psychologist
Primary
PS01791
RI
103T00000X
Psychologist

Other

Enumeration date
05/13/2020
Last updated
08/28/2025
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