Provider Demographics
NPI:1720614951
Name:BARTELL, ADRIENNE (HIS)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:
Last Name:BARTELL
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 HOUSATONIC DR
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-4941
Mailing Address - Country:US
Mailing Address - Phone:203-952-5262
Mailing Address - Fax:
Practice Address - Street 1:301 HOUSATONIC DR
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-4941
Practice Address - Country:US
Practice Address - Phone:203-952-5262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-19
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000411237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist