Provider Demographics
NPI:1194554279
Name:CONSTANTINO, PATRICIA (CPC-I, NCC)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:CONSTANTINO
Suffix:
Gender:F
Credentials:CPC-I, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 AIRMOTIVE WAY STE 260
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-3284
Mailing Address - Country:US
Mailing Address - Phone:775-737-9001
Mailing Address - Fax:
Practice Address - Street 1:1325 AIRMOTIVE WAY STE 260
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-3284
Practice Address - Country:US
Practice Address - Phone:775-737-9001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVCI5400101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional