MEDICARE: MICHELLE TOMASSO

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	106H00000X	Marriage & Family Therapist	MHC00731	RI

General Provider Information

NPI Number	:	1457729543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE TOMASSO

Provider Business Mailing Address
First Line	:	150 GARDEN HILLS DR
Second Line	:
City	:	CRANSTON
State	:	RI
Zip	:	02920-3314
Country	:	US
Telephone Number	:	401-465-2719
Fax Number	:

Provider Business Practice Location Address
First Line	:	150 GARDEN HILLS DR
Second Line	:
City	:	CRANSTON
State	:	RI
Zip	:	02920-3314
Country	:	US
Telephone Number	:	401-465-2719
Fax Number	:

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

Provider Enumeration Date	:	09/08/2015
Last Update Date	:	09/08/2015

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Directions to “ MICHELLE TOMASSO ” Practice Location

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