Basic Information
| Provider Information | |||||||||
| NPI: | 1750579355 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DALRYMPLE | ||||||||
| FirstName: | KRISTY | ||||||||
| MiddleName: | LEE | ||||||||
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| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 117 ELLENFIELD ST # 101 | ||||||||
| Address2: | |||||||||
| City: | PROVIDENCE | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029054513 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4014444318 | ||||||||
| FaxNumber: | 4014446912 | ||||||||
| Practice Location | |||||||||
| Address1: | 146 W RIVER ST | ||||||||
| Address2: | SUITE 11B | ||||||||
| City: | PROVIDENCE | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029042609 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4014447442 | ||||||||
| FaxNumber: | 4014447109 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/09/2007 | ||||||||
| LastUpdateDate: | 03/17/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | PS01032 | RI | N | Behavioral Health & Social Service Providers | Psychologist | 103TC0700X | PS01032 | RI | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.