Provider Demographics
NPI:1831359975
Name:WHIPPLE, DIANE (PHD)
Entity type:Individual
Prefix:DR
First Name:DIANE
Middle Name:
Last Name:WHIPPLE
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 1:35 S COUNTY COMMONS WAY
Mailing Address - Street 2:
Mailing Address - City:SOUTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02879-8240
Mailing Address - Country:US
Mailing Address - Phone:401-388-0556
Mailing Address - Fax:401-566-8935
Practice Address - Street 1:35 S COUNTY COMMONS WAY
Practice Address - Street 2:
Practice Address - City:SOUTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02879-8240
Practice Address - Country:US
Practice Address - Phone:401-388-0556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-12
Last Update Date:2023-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103G00000X, 103T00000X
RI1069103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist