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General NPI Number Information
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NPI Number | 1902492028
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Entity Type | Individual
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Provider Name | VICTORIA FANELLI MS
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Gender | Female
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Dates
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Enumeration Date | 12/13/2020
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 519 HERITAGE RD STE 1E
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City | SOUTHBURY
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State | CT
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Zip | 06488-1699
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Country | US
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Telephone | 475-239-5512
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Fax |
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Provider Business Mailing Address
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Address Line | 14 LISBON TER
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City | OXFORD
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State | CT
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Zip | 06478-1804
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Country | US
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Telephone | 203-571-9890
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 006235
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License Number State | CT
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