Provider Demographics
NPI:1306270343
Name:DUSSAULT-FELIPE, CRYSTAL LEE (PHD)
Entity type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:LEE
Last Name:DUSSAULT-FELIPE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1485 S COUNTY TRL UNIT 107
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-1771
Mailing Address - Country:US
Mailing Address - Phone:401-785-0040
Mailing Address - Fax:401-941-7847
Practice Address - Street 1:1485 S COUNTY TRL UNIT 107
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-1771
Practice Address - Country:US
Practice Address - Phone:401-785-0040
Practice Address - Fax:401-941-7847
Is Sole Proprietor?:No
Enumeration Date:2013-08-27
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS01345103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical