Provider Demographics
NPI:1033359690
Name:CILIO-RHEA, TARA (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:TARA
Middle Name:
Last Name:CILIO-RHEA
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:MISS
Other - First Name:TARA
Other - Middle Name:
Other - Last Name:CILIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:5300 KEMPSRIVER DR STE 10
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-5369
Mailing Address - Country:US
Mailing Address - Phone:757-392-7161
Mailing Address - Fax:757-300-5589
Practice Address - Street 1:5300 KEMPSRIVER DR STE 10
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-5369
Practice Address - Country:US
Practice Address - Phone:757-392-7161
Practice Address - Fax:757-300-5589
Is Sole Proprietor?:No
Enumeration Date:2009-02-23
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202005671235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1841271830Medicaid