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General NPI Number Information
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NPI Number | 1164613154
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Entity Type | Organization
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Legal Business Name | GINA BREGGIA-PINE, LICSW
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Dates
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Enumeration Date | 08/06/2007
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 1 RICHMOND SQ STE 130C
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City | PROVIDENCE
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State | RI
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Zip | 02906-5155
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Country | US
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Telephone | 401-944-2270
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Fax | 401-944-0026
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Provider Business Mailing Address
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Address Line | PO BOX 165
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City | BARRINGTON
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State | RI
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Zip | 02806-0165
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Country | US
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Telephone | 401-944-2270
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Fax | 401-944-0026
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | MS. GINA M PINE
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Credential | LICSW
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Telephone | 401-944-2270
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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