Provider Demographics
NPI:1114566957
Name:GIORGI, KELLY (EDD)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:
Last Name:GIORGI
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601B SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:BARRE
Mailing Address - State:MA
Mailing Address - Zip Code:01005-8822
Mailing Address - Country:US
Mailing Address - Phone:978-257-2079
Mailing Address - Fax:
Practice Address - Street 1:1601B SOUTH ST
Practice Address - Street 2:
Practice Address - City:BARRE
Practice Address - State:MA
Practice Address - Zip Code:01005-8822
Practice Address - Country:US
Practice Address - Phone:978-257-2079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-26
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool