Individual
MISS BRIANNA MARIE WALLBANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
249 ROOSEVELT AVE UNIT 205, PAWTUCKET, RI 02860-2134
(401) 724-8400
Mailing address
600 COLE FARM RD UNIT B5, WARWICK, RI 02889-1366
(401) 219-6892
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
744
RI
Other
Enumeration date
02/20/2020
Last updated
01/08/2026
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