Nicole Antilli

Individual provider Active NPI Developmental Therapist · Cromwell, CT

NPI 1225873193 · NPPES record last updated Jul 1, 2024

Key facts

NPI
1225873193
Entity type
Individual (NPI type 1)
Primary specialty
Developmental Therapist 222Q00000X
Practice address
110 Court St
Cromwell, CT 06416-1273
Phone
(860) 613-9930
Fax
(860) 613-9952
NPI assigned
Jul 1, 2024
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X Yes

Addresses

Primary practice location

110 Court St
Cromwell, CT 06416-1273

Mailing address

110 Court St
Cromwell, CT 06416-1273
Phone (860) 613-9930

Other providers in Cromwell, CT

All providers in Cromwell, CT · Developmental Therapist in Connecticut

Sources for this page

Verify at the official NPI Registry.