Individual
MS. CARLA ANNE CIPOLLONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
11551 SQUIRREL CREEK RD, GRASS VALLEY, CA 95945-4644
(530) 559-7095
Mailing address
11551 SQUIRREL CREEK RD, GRASS VALLEY, CA 95945-4644
(530) 559-7095
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
11300
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11300
STATE OF CALIFORNIA DEPARTMENT OF CONSUMER AFFAIRS
CA
Enumeration date
01/28/2021
Last updated
01/28/2021
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