Doctor Name: | REBECCA C CICCARELLI |
NPI Number: | 1881878304 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS CCC/SLP |
License Number: | 5123-SL |
Business Practice Address: | 5865 Millwick Dr Johns Creek, GA - 300056733 |
Business Phone Number: | 7705590129 |
Business Fax Number: | |
Mailing Address: | 5865 Millwick Dr, JOHNS CREEK |
State: | GA |
Postal Code: | 300056733 |
Phone Number: | 7705590129 |
Fax Number: | |
NPI Enumeration Date: | 12/19/2007 |
NPI Last Update Date: | 09/24/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 5123-SL |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MA |
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 |