Provider Demographics
NPI:1972565752
Name:FLAM, PATRICIA (PHD)
Entity type:Individual
Prefix:MISS
First Name:PATRICIA
Middle Name:
Last Name:FLAM
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 1:23 CHAMPLIN RD
Mailing Address - Street 2:
Mailing Address - City:SAUNDERSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02874-3315
Mailing Address - Country:US
Mailing Address - Phone:401-294-3236
Mailing Address - Fax:
Practice Address - Street 1:593 EDDY ST
Practice Address - Street 2:POB 122
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4923
Practice Address - Country:US
Practice Address - Phone:401-444-4515
Practice Address - Fax:401-444-7018
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS00832103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIPS00832OtherSTATE LICENSE