Provider Demographics
NPI:1114277985
Name:METRIK, JANE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:
Last Name:METRIK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX G-S121-4
Mailing Address - Street 2:CENTER FOR ALCOHOL AND ADDICTION STUDIES, BROWN UNIVERS
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02912
Mailing Address - Country:US
Mailing Address - Phone:401-863-6650
Mailing Address - Fax:
Practice Address - Street 1:142 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-3604
Practice Address - Country:US
Practice Address - Phone:401-863-6650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS01010103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist