Provider Demographics
NPI:1346569860
Name:CICALE, JUDITH ANN (CCC-A, F-AAA)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:ANN
Last Name:CICALE
Suffix:
Gender:F
Credentials:CCC-A, F-AAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 NW 43RD STREET
Mailing Address - Street 2:SUITE 1
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-2557
Mailing Address - Country:US
Mailing Address - Phone:352-271-5373
Mailing Address - Fax:352-271-5393
Practice Address - Street 1:500 NW 43RD STREET
Practice Address - Street 2:SUITE 1
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-2557
Practice Address - Country:US
Practice Address - Phone:352-271-5373
Practice Address - Fax:352-271-5393
Is Sole Proprietor?:No
Enumeration Date:2010-05-24
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1057231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist