Provider Demographics
NPI:1407608987
Name:VITIELLO, PATRICIA (CD, CPD, CBC, CBE)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:VITIELLO
Suffix:
Gender:F
Credentials:CD, CPD, CBC, CBE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10511 EQUESTRIAN TRL APT 327
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-6680
Mailing Address - Country:US
Mailing Address - Phone:862-599-0715
Mailing Address - Fax:
Practice Address - Street 1:10511 EQUESTRIAN TRL APT 327
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-6680
Practice Address - Country:US
Practice Address - Phone:862-599-0715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
6700374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula