Provider Demographics
NPI:1205183092
Name:CECIL, PAMELA (SLP)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:
Last Name:CECIL
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 SE 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-7030
Mailing Address - Country:US
Mailing Address - Phone:954-421-8957
Mailing Address - Fax:
Practice Address - Street 1:950 PENINSULA CORPORATE CIR
Practice Address - Street 2:SUITE 1014
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-1378
Practice Address - Country:US
Practice Address - Phone:561-994-6590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-10
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist