Provider Demographics
NPI:1841427325
Name:UMASCHI, STEPHANIE SHEPARD (PHD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:SHEPARD
Last Name:UMASCHI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:ANNE
Other - Last Name:SHEPARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:1011 VETERANS MEMORIAL PKWY
Mailing Address - Street 2:BRADLEY RESEARCH CENTER
Mailing Address - City:RIVERSIDE
Mailing Address - State:RI
Mailing Address - Zip Code:02915-5061
Mailing Address - Country:US
Mailing Address - Phone:401-793-8723
Mailing Address - Fax:401-793-8799
Practice Address - Street 1:1011 VETERANS MEMORIAL PKWY
Practice Address - Street 2:BRADLEY RESEARCH CENTER
Practice Address - City:RIVERSIDE
Practice Address - State:RI
Practice Address - Zip Code:02915-5061
Practice Address - Country:US
Practice Address - Phone:401-793-8723
Practice Address - Fax:401-793-8799
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS01008103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent