Most Relevant Information
Provider Data
| NPI Number: | 1003472200 |
| Provider Name: | VAMSI C TUMMALACHETTY PSYD |
| Entity Type: | Individual |
| Taxonomy Code: | 103TC0700X |
| Specialty: | Psychologist |
| License Number: | 06567 |
Most Important Dates
| Enumeration Date: | 05/13/2019 |
| Last Updated: | 12/22/2021 |
Provider Practice Location
1011 VETERANS MEMORIAL PKWY
RIVERSIDE
RI
029155061
Practice Location Phone/Fax
| Phone: | 4014321000 |
| Fax: |
Provider Mailing Location
117 ELLENFIELD ST STE 101
PROVIDENCE
RI
029054541
Provider Mailing Phone/Fax
| Phone: | 4014446779 |
| Fax: |