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General NPI Number Information
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NPI Number | 1295214955
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Entity Type | Individual
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Provider Name | JILLIAN D'ANGELO
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Gender | Female
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Dates
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Enumeration Date | 08/13/2018
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Last Update Date | 01/20/2023
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Provider Practice Location Address
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Address Line | 99 S MAIN ST STE 10
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City | FALL RIVER
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State | MA
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Zip | 02721-5349
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Country | US
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Telephone | 800-697-3609
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Fax |
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Provider Business Mailing Address
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Address Line | 275 W NATICK RD STE 400
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City | WARWICK
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State | RI
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Zip | 02886-1161
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Country | US
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Telephone |
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP01465
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License Number State | RI
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