Provider Demographics
NPI:1427688969
Name:VELTRE-TOPOLOSKY, NICOLE IRMGARD (MED)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:IRMGARD
Last Name:VELTRE-TOPOLOSKY
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1351 PEACHTREE LN
Mailing Address - Street 2:
Mailing Address - City:IRWIN
Mailing Address - State:PA
Mailing Address - Zip Code:15642-5500
Mailing Address - Country:US
Mailing Address - Phone:412-999-1314
Mailing Address - Fax:
Practice Address - Street 1:1351 PEACHTREE LN
Practice Address - Street 2:
Practice Address - City:IRWIN
Practice Address - State:PA
Practice Address - Zip Code:15642-5500
Practice Address - Country:US
Practice Address - Phone:412-999-1314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-23
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH001924103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst