| Doctor Name: | DR. CONCETTA MARY DI LEONARDO |
| NPI Number: | 1073540928 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | PS00095 |
| Business Practice Address: | 1351 S County Trl Building 2--suite 210 East Greenwich, RI - 028185079 |
| Business Phone Number: | 4018842008 |
| Business Fax Number: | 4018842075 |
| Mailing Address: | 32 Juniper Hill Dr, COVENTRY |
| State: | RI |
| Postal Code: | 028166434 |
| Phone Number: | 4018270728 |
| Fax Number: | 4014573371 |
| NPI Enumeration Date: | 06/27/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PS00095 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | RI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |