Provider Information for 1699226837
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Miss MISTY APRIL FAELLA MA
Sex: Female
NPI: 1699226837
Last Updated: 2016-10-24
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1699226837 | ||||||||
| Enumeration Date | 2016-10-24 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 153 SUMMER STREET PROVIDENCE, RI 02903 United States Phone: 401-276-4325 | Fax:401-331-3285 | ||||||||
| Primary Practice Address | 153 SUMMER STREET PROVIDENCE, RI 02903 United States Phone: 401-276-4325 | Fax:401-331-3285 | ||||||||
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