Provider Demographics
NPI:1164022075
Name:IANDIORIO, CIERA MARIE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CIERA
Middle Name:MARIE
Last Name:IANDIORIO
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 VALLEY RD APT 204
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-2799
Mailing Address - Country:US
Mailing Address - Phone:973-349-0323
Mailing Address - Fax:
Practice Address - Street 1:34 VALLEY RD APT 204
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-2799
Practice Address - Country:US
Practice Address - Phone:973-349-0323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-29
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS01160500235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist