Provider Demographics
NPI:1639398324
Name:BURMAN, LETICIA BUONANNO (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LETICIA
Middle Name:BUONANNO
Last Name:BURMAN
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 1:176 TOLL GATE ROAD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-4481
Mailing Address - Country:US
Mailing Address - Phone:401-739-1010
Mailing Address - Fax:401-739-1110
Practice Address - Street 1:176 TOLL GATE ROAD
Practice Address - Street 2:SUITE 303
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-4481
Practice Address - Country:US
Practice Address - Phone:401-739-1010
Practice Address - Fax:401-739-1110
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health