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General NPI Number Information
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NPI Number | 1760081921
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Entity Type | Individual
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Provider Name | TORI LYNN PANZARELLA LMHC
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Gender | Female
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Dates
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Enumeration Date | 10/20/2020
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Last Update Date | 12/14/2020
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Provider Practice Location Address
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Address Line | 215 HIGH ST
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City | BRISTOL
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State | RI
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Zip | 02809-2210
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Country | US
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Telephone | 401-237-0680
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Fax | 401-589-1583
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Provider Business Mailing Address
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Address Line | 155 MOUNT HOPE AVE APT 1
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City | BRISTOL
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State | RI
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Zip | 02809-3560
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Country | US
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Telephone | 401-297-1337
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MCH01171
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License Number State | RI
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