Provider Demographics
NPI:1457848145
Name:PIANTINO, PAOLLA GIANOTTI
Entity Type:Individual
Prefix:
First Name:PAOLLA
Middle Name:GIANOTTI
Last Name:PIANTINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 W BOYNTON BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-3506
Mailing Address - Country:US
Mailing Address - Phone:800-686-5614
Mailing Address - Fax:
Practice Address - Street 1:6400 W BOYNTON BEACH BLVD
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3506
Practice Address - Country:US
Practice Address - Phone:800-686-5614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-18
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst