Provider Demographics
NPI:1760534952
Name:WELD, TANIA MAFALDA CORNELIO (MFT)
Entity Type:Individual
Prefix:MRS
First Name:TANIA
Middle Name:MAFALDA CORNELIO
Last Name:WELD
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:TANIA
Other - Middle Name:MAFALDA
Other - Last Name:CORNELIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT
Mailing Address - Street 1:5 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02917
Mailing Address - Country:US
Mailing Address - Phone:617-429-9610
Mailing Address - Fax:
Practice Address - Street 1:1471 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02910-3849
Practice Address - Country:US
Practice Address - Phone:401-490-7320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health