Provider Demographics
NPI:1710792148
Name:AMODEI, PATRICIA MERCURIO (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:MERCURIO
Last Name:AMODEI
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 SORGHUM MILL DRIVE
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410
Mailing Address - Country:US
Mailing Address - Phone:203-606-4369
Mailing Address - Fax:
Practice Address - Street 1:300 CHURCH STREET
Practice Address - Street 2:UNIT 102
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492
Practice Address - Country:US
Practice Address - Phone:203-410-0974
Practice Address - Fax:888-980-7890
Is Sole Proprietor?:No
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004119235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist