| Organization Name: | STEPHEN J. ANTONELLO, INCORPORATED |
| NPI Number: | 1326147133 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STEPHEN JOHN ANTONELLO (LICENSED PSYCHOLOGIST) |
| Mailing Address: | 1700 Livingston Ave Suite 215 West St Paul |
| State: | MN US |
| Postal Code: | 551185908 |
| Phone Number: | 6516882335 |
| Fax Number: | 6516882669 |
| NPI Enumeration Date: | 09/21/2006 |
| NPI Last Update Date: | 04/10/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | LP1390 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |