Individual
DIANE CICCARELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.D
Contact information
Practice address
1225 SE PARAKEET LN, STUART, FL 34994-3421
(772) 708-4883
(772) 210-6834
Mailing address
1225 SE PARAKEET LN, STUART, FL 34994-3421
(772) 708-4883
(772) 210-6834
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
681856196
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
681856168
—
FL
05
—
681856196
—
FL
05
—
681856198
—
FL
Enumeration date
03/17/2007
Last updated
04/28/2017
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