Chonlada Jarukitisakul, PhD
Psychologist in Providence, RI. Individual provider (NPI-1).
NPI number1962024869
StatusActive
Last updated in NPPESAug 13, 2026
Details
- NPI
- 1962024869
- Entity type
- Individual (NPI-1)
- Name
- Chonlada Jarukitisakul
- Credential
- PhD
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 13, 2020
- Certification date
- Aug 13, 2026
- Last updated
- Aug 13, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103T00000X | Psychologist | PS01791 | RI | Yes |
| 103T00000X | Psychologist | – | – | |
| 103T00000X | Psychologist | 11069-PY-PR | MA |
Practice location
450 Brook StreetProvidence, RI 02906
Phone 401-863-3476
Mailing address
69 Brown Street Box 1960Providence, RI 02912-0001
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