Provider Demographics
NPI:1659135523
Name:PATINHA, ARACELI CHAVEZ
Entity Type:Individual
Prefix:
First Name:ARACELI
Middle Name:CHAVEZ
Last Name:PATINHA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 TOLL GATE RD
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-1055
Mailing Address - Country:US
Mailing Address - Phone:860-918-7400
Mailing Address - Fax:
Practice Address - Street 1:32 TOLL GATE RD
Practice Address - Street 2:
Practice Address - City:WETHERSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06109-1055
Practice Address - Country:US
Practice Address - Phone:860-918-7400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-09
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT7541101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty