Surguladze, Tinatin

Surguladze, Tinatin is an individual health care provider with primary practice located at 205 Waterman St Suite 106 , Providence RI 02906. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Surguladze, Tinatin can be contacted via phone (857) 333-0533.

Contact Information

Primary practice address
205 Waterman St Suite 106 Providence RI 02906
Phone: (857) 333-0533
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Behavioral Health & Social Service Providers / Psychologist 103T00000X 11259 Massachusetts
Behavioral Health & Social Service Providers / Psychologist 103T00000X PS01795 Rhode Island

Profile Details

NPI number 1700289360
LBN Legal business name Surguladze, Tinatin
Credentials DH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2014
Last updated Apr 29th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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