MEDICARE: MRS. ALEXANDRA DIPIETRO SZABO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	101YM0800X	Mental Health Counselor	MHC00648	RI

General Provider Information

NPI Number	:	1245545599
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALEXANDRA DIPIETRO SZABO

Provider Business Mailing Address
First Line	:	320 PHILLIPS ST
Second Line	:	SUITE 103
City	:	NORTH KINGSTOWN
State	:	RI
Zip	:	02852-5166
Country	:	US
Telephone Number	:	401-529-5255
Fax Number	:

Provider Business Practice Location Address
First Line	:	320 PHILLIPS ST
Second Line	:	SUITE 103
City	:	NORTH KINGSTOWN
State	:	RI
Zip	:	02852-5166
Country	:	US
Telephone Number	:	401-529-5255
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2010
Last Update Date	:	04/06/2017

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