Individual
JULIE IANNICELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
24 RIVERGATE DR, CROMWELL, CT 06416-1522
(860) 818-8266
Mailing address
24 RIVERGATE DR, CROMWELL, CT 06416-1522
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000959
CT
Other
Enumeration date
01/23/2015
Last updated
01/23/2015
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