Provider Demographics
NPI:1629592662
Name:QUIGLEY, CIERRA RYAN (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:CIERRA
Middle Name:RYAN
Last Name:QUIGLEY
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 1:2916 LOCHCARRON DR
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34638-7865
Mailing Address - Country:US
Mailing Address - Phone:239-220-9590
Mailing Address - Fax:
Practice Address - Street 1:18946 N DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33548-4900
Practice Address - Country:US
Practice Address - Phone:813-388-5334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-01
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA15600235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist