Provider Demographics
NPI:1003955634
Name:SABO, RHONDA L (PSYD)
Entity Type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:L
Last Name:SABO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02909-1143
Mailing Address - Country:US
Mailing Address - Phone:401-453-5100
Mailing Address - Fax:
Practice Address - Street 1:341 BROADWAY
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02909-1143
Practice Address - Country:US
Practice Address - Phone:401-453-5100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS00595103TC0700X
MA7409103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI2712-8OtherBLUE CROSS BLUE SHIELD
MA2004120103151177-001OtherMAGELLAN
RI01-73459OtherUNITED HEALTHCARE
RI410786OtherBLUECHIP