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General NPI Number Information
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NPI Number | 1992338735
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Entity Type | Individual
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Provider Name | MISS BRIANNA MARIE WALLBANK
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Gender | Female
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Dates
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Enumeration Date | 02/20/2020
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 249 ROOSEVELT AVE UNIT 205
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City | PAWTUCKET
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State | RI
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Zip | 02860-2134
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Country | US
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Telephone | 401-724-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 600 COLE FARM RD UNIT B5
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City | WARWICK
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State | RI
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Zip | 02889-1366
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Country | US
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Telephone | 401-219-6892
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 744
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License Number State | RI
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