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:
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3296 POST RD STE 2A
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-7131
Mailing Address - Country:US
Mailing Address - Phone:401-739-1010
Mailing Address - Fax:401-739-1110
Practice Address - Street 1:3296 POST RD STE 2A
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-7131
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:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
RIPS01160103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health