Provider Demographics
NPI:1164086963
Name:DEVINCENTIS, ROSALYN DELIA (PSYD)
Entity Type:Individual
Prefix:
First Name:ROSALYN
Middle Name:DELIA
Last Name:DEVINCENTIS
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 1:129 PINE ST
Mailing Address - Street 2:
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05301-6497
Mailing Address - Country:US
Mailing Address - Phone:802-380-3091
Mailing Address - Fax:
Practice Address - Street 1:9 COLLEGE ST STE 6
Practice Address - Street 2:
Practice Address - City:SOUTH HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01075-1421
Practice Address - Country:US
Practice Address - Phone:413-534-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-26
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist