Individual
LYDIA CATHERINE CICARELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPC
Contact information
Practice address
901 N MONROE ST STE 201, SPOKANE, WA 99201-2148
(509) 608-8816
Mailing address
5211 N WASHINGTON ST, SPOKANE, WA 99205-5141
(509) 216-3057
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
CG61227010
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CG61227010
—
WA
Enumeration date
12/10/2021
Last updated
12/10/2021
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