Doctor Name: | TRICIA CICCOCIOPPO |
NPI Number: | 1174778310 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA CCC-SLP |
License Number: | 103236 |
Business Practice Address: | 5555 N Lamar Blvd Ste L 103 Austin, TX - 787511073 |
Business Phone Number: | 5122002332 |
Business Fax Number: | |
Mailing Address: | 5555 N Lamar Blvd, Ste L 103 AUSTIN |
State: | TX |
Postal Code: | 787511073 |
Phone Number: | 5122002332 |
Fax Number: | |
NPI Enumeration Date: | 12/01/2008 |
NPI Last Update Date: | 02/20/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 103236 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |