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General NPI Number Information
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NPI Number | 1811271927
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Entity Type | Organization
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Legal Business Name | TANIA PATRICELLI
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Dates
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Enumeration Date | 10/07/2011
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Last Update Date | 10/08/2013
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Provider Practice Location Address
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Address Line | 173 MONTOWESE ST
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City | BRANFORD
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State | CT
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Zip | 06405-3887
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Country | US
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Telephone | 203-415-5645
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Fax |
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Provider Business Mailing Address
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Address Line | 112 CHARTER OAK AVE
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City | EAST HAVEN
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State | CT
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Zip | 06512-2775
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | MS. TANIA PATRICELLI
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Credential | LPC
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Telephone | 203-415-5645
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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