Healthcare Provider Details

I. General information

NPI: 1407563489
Provider Name (Legal Business Name): BRIANA PAULO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2022
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 RICHMOND SQ STE 300E
PROVIDENCE RI
02906-5160
US

IV. Provider business mailing address

1 RICHMOND SQ STE 300E
PROVIDENCE RI
02906-5160
US

V. Phone/Fax

Practice location:
  • Phone: 401-530-5087
  • Fax:
Mailing address:
  • Phone: 401-530-5087
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: