Provider Demographics
NPI:1083885792
Name:KALEN, PATRICIA (EDS)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:KALEN
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 FOSTER SHELDON RD
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02879-1439
Mailing Address - Country:US
Mailing Address - Phone:401-789-6092
Mailing Address - Fax:
Practice Address - Street 1:91 FOSTER SHELDON RD
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:RI
Practice Address - Zip Code:02879-1439
Practice Address - Country:US
Practice Address - Phone:401-789-6092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-20
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool