Provider Demographics
NPI:1033351812
Name:DESALVATORE, HARRY GINO
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:GINO
Last Name:DESALVATORE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 6TH AVE N
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37208-2650
Mailing Address - Country:US
Mailing Address - Phone:615-460-4128
Mailing Address - Fax:615-460-4189
Practice Address - Street 1:1101 6TH AVE N
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37208-2650
Practice Address - Country:US
Practice Address - Phone:615-460-4128
Practice Address - Fax:615-460-4189
Is Sole Proprietor?:No
Enumeration Date:2009-03-25
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor