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GREGG SELKE PH.D.

Clinical Neuropsychologist

Providence, Rhode Island

Provider NPI: 1447458708

Provider Information:
 GREGG  SELKE PH.D.
Gender: M
Not Sole Proprietor

Practice Location:
593 EDDY ST POB 430 PROVIDENCE, RI 02903 US
Tel: 401-444-4500  Fax: 401-444-6643

Business Mailing Address:
593 EDDY ST POTTER 3 PROVIDENCE, RI 02903 US
Tel: 401-444-4318  Fax: 401-444-6573

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N103TC0700XBehavioral Health & Social Service Providers
Psychologist
Clinical
RIPS01024
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
RIPS01024

Other Provider Identifiers:

IssuerNumberStateType
STATE LICENSEPS01024RI01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







CLINICAL NEUROPSYCHOLOGIST JOBS RI - Page 1



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