Provider Demographics
NPI:1245246222
Name:DOUCETTE, JOANNE LOUISE (EDD)
Entity Type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:LOUISE
Last Name:DOUCETTE
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 WAYLAND AVE LEVEL
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-4371
Mailing Address - Country:US
Mailing Address - Phone:401-871-0501
Mailing Address - Fax:401-714-0418
Practice Address - Street 1:111 WAYLAND AVENUE
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-1039
Practice Address - Country:US
Practice Address - Phone:401-871-0501
Practice Address - Fax:401-714-0418
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS00558103TC2200X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent