Individual
BRENDA EILEEN CICCARONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1311 ASBURY RD, BALTIMORE, MD 21209-3721
(443) 695-4473
Mailing address
1311 ASBURY RD, BALTIMORE, MD 21209-3721
(443) 695-4473
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
04140
MD
Other
Enumeration date
10/14/2019
Last updated
10/14/2019
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