Nicole Alyssa Pellicciotto, MEd, ABD
Developmental Therapist in Fairfax, VA. Individual provider (NPI-1).
NPI number1720200728
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1720200728
- Entity type
- Individual (NPI-1)
- Name
- Nicole Alyssa Pellicciotto
- Credential
- MEd, ABD
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 2, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 222Q00000X | Developmental Therapist | – | VA | Yes |
Other names
- Nicole Pellicciotto (Professional Name)
Practice location
11642 Leehigh DriveFairfax, VA 22030-5640
Phone 703-819-4697
Mailing address
11642 Leehigh DriveFairfax, VA 22030-5640
Phone 703-819-4697
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