Provider Demographics
NPI:1376911438
Name:PIZANO, CECELIA (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CECELIA
Middle Name:
Last Name:PIZANO
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 1:1430 WILLAMETTE ST # 125
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-4049
Mailing Address - Country:US
Mailing Address - Phone:541-799-0995
Mailing Address - Fax:
Practice Address - Street 1:41 W 22ND AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-2811
Practice Address - Country:US
Practice Address - Phone:541-799-0995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-07
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP9436235Z00000X
OR015737235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty