Provider Demographics
NPI:1043339856
Name:SEVIGNY KRENICKI, AIMEE M (ATC, PES)
Entity Type:Individual
Prefix:MS
First Name:AIMEE
Middle Name:M
Last Name:SEVIGNY KRENICKI
Suffix:
Gender:F
Credentials:ATC, PES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 GREEN HILLS RD
Mailing Address - Street 2:
Mailing Address - City:QUAKER HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06375-1108
Mailing Address - Country:US
Mailing Address - Phone:603-557-4959
Mailing Address - Fax:
Practice Address - Street 1:270 MOHEGAN AVE
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:CT
Practice Address - Zip Code:06320-4150
Practice Address - Country:US
Practice Address - Phone:860-439-2679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH03232255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer