Provider Demographics
NPI:1659527612
Name:INCLIMA, ANTOINETTE INCLIMA
Entity Type:Individual
Prefix:MRS
First Name:ANTOINETTE INCLIMA
Middle Name:
Last Name:INCLIMA
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 1:16 TILLOTSON PL
Mailing Address - Street 2:
Mailing Address - City:TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14223-2829
Mailing Address - Country:US
Mailing Address - Phone:716-432-8214
Mailing Address - Fax:
Practice Address - Street 1:16 TILLOTSON PL
Practice Address - Street 2:
Practice Address - City:TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14223-2829
Practice Address - Country:US
Practice Address - Phone:716-432-8214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-11
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008153-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist