Provider Demographics
NPI:1144547639
Name:SCIOLI, ANTONIO (PHD)
Entity type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:
Last Name:SCIOLI
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSYCHOLOGY DEPARTMENT KEENE STATE COLLEGE
Mailing Address - Street 2:229 MAIN STREET
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03435-0001
Mailing Address - Country:US
Mailing Address - Phone:781-254-9156
Mailing Address - Fax:
Practice Address - Street 1:9 DAMONMILL SQ
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-2858
Practice Address - Country:US
Practice Address - Phone:781-254-9156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-23
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7357103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA7357OtherPSYCHOLOGY LICENSED HEALTH SERVICE PROVIDER