Provider Demographics
NPI:1629320411
Name:DAMRAD, ANNE E (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:E
Last Name:DAMRAD
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 1:2131 FRENCHTOWN ROAD
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-1018
Mailing Address - Country:US
Mailing Address - Phone:401-885-7856
Mailing Address - Fax:401-885-7856
Practice Address - Street 1:2131 FRENCHTOWN ROAD
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-1018
Practice Address - Country:US
Practice Address - Phone:401-885-7856
Practice Address - Fax:401-885-7856
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-04
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS01204103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist