Provider Demographics
NPI:1619160306
Name:RIETANO, SHEILA M (MSW)
Entity Type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:M
Last Name:RIETANO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 EAST AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-5024
Mailing Address - Country:US
Mailing Address - Phone:203-866-9199
Mailing Address - Fax:203-454-0544
Practice Address - Street 1:94 EAST AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-5024
Practice Address - Country:US
Practice Address - Phone:203-866-9199
Practice Address - Fax:203-454-0544
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-25
Last Update Date:2007-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002613101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health