Provider Demographics
NPI:1225180953
Name:BARBERA, MONA R (PHD)
Entity Type:Individual
Prefix:
First Name:MONA
Middle Name:R
Last Name:BARBERA
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 1:341 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:401-272-2029
Mailing Address - Fax:610-514-5466
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:401-272-2029
Practice Address - Fax:610-514-5466
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS00735103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist