Individual
JOELLE SERVELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1000 EDDY ST, PROVIDENCE, RI 02905-4739
(401) 533-9100
Mailing address
1000 EDDY ST, PROVIDENCE, RI 02905-4739
(401) 533-9100
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
10200
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0614
NEIGHBORHOOD HEALTH PLAN
RI
05
—
ES01788
—
RI
01
—
SB870
BLUE CROSS
RI
Enumeration date
06/13/2011
Last updated
08/27/2015
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