Provider Demographics
NPI:1912631888
Name:CONNELL, CIARA NEVE
Entity Type:Individual
Prefix:MISS
First Name:CIARA
Middle Name:NEVE
Last Name:CONNELL
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 1:279 S 5TH ST APT 3
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-6242
Mailing Address - Country:US
Mailing Address - Phone:847-287-9461
Mailing Address - Fax:
Practice Address - Street 1:117 DOBBIN ST STE 204A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222-2803
Practice Address - Country:US
Practice Address - Phone:347-255-1747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-14
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt TherapistGroup - Multi-Specialty