Provider Demographics
NPI:1932133915
Name:REY, JANNETTE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JANNETTE
Middle Name:
Last Name:REY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:JANNETTE
Other - Middle Name:REY
Other - Last Name:TODARO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:616 HOPE ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-2659
Mailing Address - Country:US
Mailing Address - Phone:401-369-9924
Mailing Address - Fax:401-369-9275
Practice Address - Street 1:616 HOPE ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-2659
Practice Address - Country:US
Practice Address - Phone:401-369-9924
Practice Address - Fax:401-369-9275
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS00894103TB0200X, 103TC0700X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent