Healthcare Provider Details

I. General information

NPI: 1063273779
Provider Name (Legal Business Name): TALIA DIGIULIO SIMAO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2024
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 PINEWOOD DR
SMITHFIELD RI
02917-3127
US

IV. Provider business mailing address

202 PINEWOOD DR
SMITHFIELD RI
02917-3127
US

V. Phone/Fax

Practice location:
  • Phone: 401-573-6409
  • Fax:
Mailing address:
  • Phone: 401-573-6409
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberISW04844
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: