Individual
LAURA DENISE CICCARELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
3520 W MONTAGUE AVE STE 104, NORTH CHARLESTON, SC 29418-6083
(843) 735-5086
(843) 735-5097
Mailing address
337 MOLASSES LN, MT PLEASANT, SC 29464-2520
(843) 735-5086
(843) 735-5097
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
170300000X
Genetic Counselor (M.S.)
Primary
388
SC
Other
Enumeration date
05/26/2023
Last updated
08/06/2026
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