Provider Demographics
NPI:1346915709
Name:ROMANELLI, HOLLY A (BCBA)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:A
Last Name:ROMANELLI
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 LOCKWOOD ST
Mailing Address - Street 2:
Mailing Address - City:WEST WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02893-2109
Mailing Address - Country:US
Mailing Address - Phone:401-575-2971
Mailing Address - Fax:
Practice Address - Street 1:64 LOCKWOOD ST
Practice Address - Street 2:
Practice Address - City:WEST WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02893-2109
Practice Address - Country:US
Practice Address - Phone:401-575-2971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-09
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILBA00120103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst