Provider Demographics
NPI:1205062205
Name:COLICCI-FAVRETTO, NATALIE (ND)
Entity type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:
Last Name:COLICCI-FAVRETTO
Suffix:
Gender:F
Credentials:ND
Other - Prefix:DR
Other - First Name:NATALIE
Other - Middle Name:
Other - Last Name:COLICCI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ND
Mailing Address - Street 1:2 CORPORATE DR STE 206
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-1376
Mailing Address - Country:US
Mailing Address - Phone:203-371-1021
Mailing Address - Fax:203-371-1022
Practice Address - Street 1:2 CORPORATE DR STE 206
Practice Address - Street 2:
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-1376
Practice Address - Country:US
Practice Address - Phone:203-371-1021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-03
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000843133N00000X
CT000420175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No133N00000XDietary & Nutritional Service ProvidersNutritionist