Provider Demographics
NPI:1477639177
Name:IONELLI, CATHERINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:
Last Name:IONELLI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:IONELLI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:6423 POINT HANCOCK DR
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-8765
Mailing Address - Country:US
Mailing Address - Phone:239-595-1217
Mailing Address - Fax:
Practice Address - Street 1:314 E PLANT ST
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-3133
Practice Address - Country:US
Practice Address - Phone:239-595-1217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8921103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical