Provider Demographics
NPI:1457643454
Name:ANNE DAVIDGE CHACE
Entity Type:Organization
Organization Name:ANNE DAVIDGE CHACE
Other - Org Name:ANNE DAVIDGE PH.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:401-624-9972
Mailing Address - Street 1:2128 MAIN RD
Mailing Address - Street 2:
Mailing Address - City:TIVERTON
Mailing Address - State:RI
Mailing Address - Zip Code:02878-4609
Mailing Address - Country:US
Mailing Address - Phone:401-624-9972
Mailing Address - Fax:401-624-1452
Practice Address - Street 1:2128 MAIN RD
Practice Address - Street 2:
Practice Address - City:TIVERTON
Practice Address - State:RI
Practice Address - Zip Code:02878-4609
Practice Address - Country:US
Practice Address - Phone:401-624-9972
Practice Address - Fax:401-624-1452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-09
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI413103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty