Provider Demographics
NPI:1134937667
Name:ROMANELLI, NICOLE (CCLS)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:ROMANELLI
Suffix:
Gender:F
Credentials:CCLS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 MERRIMAN RD
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06095-1021
Mailing Address - Country:US
Mailing Address - Phone:860-874-8581
Mailing Address - Fax:
Practice Address - Street 1:424 MERRIMAN RD
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06095-1021
Practice Address - Country:US
Practice Address - Phone:860-874-8581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
19665174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist