Provider Demographics
NPI:1063228666
Name:GNYS, JUDITH A (PHD)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:A
Last Name:GNYS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 PINE TREE LN
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-4569
Mailing Address - Country:US
Mailing Address - Phone:401-663-6400
Mailing Address - Fax:
Practice Address - Street 1:3 PINE TREE LN
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-4569
Practice Address - Country:US
Practice Address - Phone:401-663-6400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS00541103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty