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General NPI Number Information
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NPI Number | 1518414689
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Entity Type | Organization
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Legal Business Name | JO-ANN L. DONATELLI, PH.D., INC.
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Dates
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Enumeration Date | 09/07/2016
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Last Update Date | 09/07/2016
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Provider Practice Location Address
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Address Line | 1 RICHMOND SQUARE SUITE 154E
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City | PROVIDENCE
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State | RI
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Zip | 02906-5100
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Country | US
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Telephone | 401-533-9994
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Fax | 401-531-1532
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Provider Business Mailing Address
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Address Line | 1 RICHMOND SQUARE SUITE 100C
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City | PROVIDENCE
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State | RI
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Zip | 02906-5154
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Country | US
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Telephone | 401-533-9994
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Fax | 401-531-1532
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. JO-ANN LYNN DONATELLI
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Credential | PHD
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Telephone | 401-569-7640
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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 | PS01056
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License Number State | RI
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