Provider Demographics
NPI:1285066225
Name:GIOVANNELLI, THORAYYA SAID (PSYD)
Entity type:Individual
Prefix:DR
First Name:THORAYYA
Middle Name:SAID
Last Name:GIOVANNELLI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:MS
Other - First Name:THORAYYA
Other - Middle Name:AHMED
Other - Last Name:SAID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1855 W CITY DR
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-9633
Mailing Address - Country:US
Mailing Address - Phone:252-331-2191
Mailing Address - Fax:
Practice Address - Street 1:1855 W CITY DR
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-9633
Practice Address - Country:US
Practice Address - Phone:252-331-2191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-01
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004795103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical