Healthcare Provider Details
I. General information
NPI: 1871058313
Provider Name (Legal Business Name): GIANNINA CIPOLLONI MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/08/2019
Last Update Date: 02/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
17 BARCLAY STREET BUILDING A/B
NEWTOWN PA
18940
US
IV. Provider business mailing address
444 S. STATE STREET BUILDING A/B
NEWTOWN PA
18940
US
V. Phone/Fax
- Phone: 267-980-9346
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: