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General NPI Number Information
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NPI Number | 1942235122
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Entity Type | Individual
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Provider Name | SAMUEL LOUIS CIOTOLA JR. MS, LMFT
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Gender | Male
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 08/14/2013
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Provider Practice Location Address
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Address Line | 652 GEORGE WASHINGTON HWY SUITE 102
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City | LINCOLN
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State | RI
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Zip | 02865-4330
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Country | US
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Telephone | 401-475-9979
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Fax | 401-475-9917
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Provider Business Mailing Address
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Address Line | 23 MELLO ST
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City | WEST WARWICK
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State | RI
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Zip | 02893-4109
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Country | US
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Telephone | 401-787-6926
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT000094
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License Number State | RI
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