Provider Demographics
NPI:1447626023
Name:DAVIDOFF, KRISTIN (MA)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:DAVIDOFF
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 DANIELSON PIKE
Mailing Address - Street 2:
Mailing Address - City:NORTH SCITUATE
Mailing Address - State:RI
Mailing Address - Zip Code:02857-1892
Mailing Address - Country:US
Mailing Address - Phone:401-895-7897
Mailing Address - Fax:401-296-3995
Practice Address - Street 1:1170 PONTIAC AVE
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-7944
Practice Address - Country:US
Practice Address - Phone:401-500-0424
Practice Address - Fax:401-296-3998
Is Sole Proprietor?:No
Enumeration Date:2015-08-18
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS01720103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical