Provider Demographics
NPI:1457238438
Name:SKRZYNIARZ, NICOLE MARTINO
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:MARTINO
Last Name:SKRZYNIARZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:NICOLEQ
Other - Middle Name:ELISE
Other - Last Name:MARTINO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:492 OAK AVE APT 39
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-3018
Mailing Address - Country:US
Mailing Address - Phone:203-518-0757
Mailing Address - Fax:
Practice Address - Street 1:492 OAK AVE APT 39
Practice Address - Street 2:
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-3018
Practice Address - Country:US
Practice Address - Phone:203-518-0757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000271103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst