Individual
MS. KATIE GANGEMELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
1011 VETERANS MEMORIAL PKWY STE 101, RIVERSIDE, RI 02915-5061
(401) 432-1000
Mailing address
117 ELLENFIELD ST STE 101, PROVIDENCE, RI 02905-4541
(401) 444-6779
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
223779
MA
1041C0700X
Clinical Social Worker
CSW02851
RI
1041C0700X
Clinical Social Worker
Primary
ISW04131
RI
Other
Enumeration date
09/25/2018
Last updated
07/23/2024
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