Provider Demographics
NPI:1437733219
Name:AUTUORI, CHRISTEL
Entity type:Individual
Prefix:MS
First Name:CHRISTEL
Middle Name:
Last Name:AUTUORI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 269
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-0269
Mailing Address - Country:US
Mailing Address - Phone:203-788-0647
Mailing Address - Fax:
Practice Address - Street 1:181 WHITE ST
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-6826
Practice Address - Country:US
Practice Address - Phone:203-837-8559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-08
Last Update Date:2021-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2282124Q00000X
171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No124Q00000XDental ProvidersDental Hygienist