Healthcare Provider Details

I. General information

NPI: 1134285257
Provider Name (Legal Business Name): DAVID JOSEPH PAGLIARO MA,LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/01/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 BLACKSTONE BLVD WELD BLDG, RM 162
PROVIDENCE RI
02906-4800
US

IV. Provider business mailing address

47 CONNOR FARM DR
SMITHFIELD RI
02917-1418
US

V. Phone/Fax

Practice location:
  • Phone: 401-480-1600
  • Fax:
Mailing address:
  • Phone: 401-233-2469
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number00091
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: