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General NPI Number Information
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NPI Number | 1194694885
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Entity Type | Individual
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Provider Name | JILLIAN GIANNINI
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Gender | Female
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Dates
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Enumeration Date | 11/01/2025
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Last Update Date | 11/01/2025
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Provider Practice Location Address
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Address Line | 2 COLCHESTER AVE
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City | BURLINGTON
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State | VT
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Zip | 05405-1764
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Country | US
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Telephone | 802-656-2661
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Fax |
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Provider Business Mailing Address
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Address Line | 370 FARRELL ST APT 123
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City | SOUTH BURLINGTON
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State | VT
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Zip | 05403-4432
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Country | US
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Telephone | 805-570-0035
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 736
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License Number State | VT
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