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Individual

DR. JUDY LEE ANTONELLO

Active
Find providers by NPI
Individual

DR. JUDY LEE ANTONELLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP0444
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100352600
MN
01
104570
UCARE
MN
01
31P64AN
BC BS GROUP ID
MN
01
31P65AN
BC BS INDIVIDUAL ID
MN
01
6146579
MEDICA
01
9233
HEALTH PARTNERS GROUP ID
MN
01
HP40905
HEALTH PARTNERS INDIVIDUA
MN
Enumeration date
09/21/2006
Last updated
02/28/2021
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If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.

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