Individual
REBECCA C CICCARELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC/SLP
Contact information
Practice address
5865 MILLWICK DR, JOHNS CREEK, GA 30005-6733
(770) 559-0129
Mailing address
5865 MILLWICK DR, JOHNS CREEK, GA 30005-6733
(770) 559-0129
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
5123-SL
MA
235Z00000X
Speech-Language Pathologist
Primary
SLP008542
GA
Other
Enumeration date
12/19/2007
Last updated
09/24/2014
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