Provider Demographics
NPI:1891433629
Name:SALVAGGIO, GIANELLA
Entity Type:Individual
Prefix:
First Name:GIANELLA
Middle Name:
Last Name:SALVAGGIO
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 1:200 MAIN ST STE 210
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-4119
Mailing Address - Country:US
Mailing Address - Phone:401-400-2826
Mailing Address - Fax:401-600-0098
Practice Address - Street 1:1 RICHMOND SQ STE 321W
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-5156
Practice Address - Country:US
Practice Address - Phone:401-400-2826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-23
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health