Individual
SAMANTHA DESALVO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
170 PONTIAC AVE # 100, CRANSTON, RI 02910-1248
(401) 895-9937
Mailing address
145 BENNETT ST, WOONSOCKET, RI 02895-4618
(401) 651-0070
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MHC00438-A
RI
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/10/2024
Last updated
01/14/2026
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