Individual
ALEXIS GRACE CICCONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7820 BALTUSROL BLVD, GAINESVILLE, VA 20155-3270
(703) 468-2750
Mailing address
203 LAVENDER BLOOM LOOP, MOORESVILLE, NC 28115-8703
(610) 500-0809
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
03/22/2023
Last updated
03/22/2023
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