Individual
COLLEEN GRACE CICERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-1000
Mailing address
1107 GORDON RD, LYNDHURST, OH 44124-1334
(440) 227-9056
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I.1000300
OH
Other
Enumeration date
02/12/2012
Last updated
02/12/2012
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