Provider Demographics
NPI:1841582376
Name:GIUSTI, LAURA M (PHD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:M
Last Name:GIUSTI
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 1:154 WATERMAN ST
Mailing Address - Street 2:3 WEST
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-3116
Mailing Address - Country:US
Mailing Address - Phone:401-274-0834
Mailing Address - Fax:401-272-3221
Practice Address - Street 1:154 WATERMAN ST
Practice Address - Street 2:3 WEST
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-3116
Practice Address - Country:US
Practice Address - Phone:401-274-0834
Practice Address - Fax:401-272-3221
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-02
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI000623103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist