Provider Demographics
NPI:1770501942
Name:CIANCIOLO, ELIZABETH P (PHD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:P
Last Name:CIANCIOLO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2951
Mailing Address - Street 2:
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24402-2951
Mailing Address - Country:US
Mailing Address - Phone:540-886-3063
Mailing Address - Fax:540-886-6246
Practice Address - Street 1:102 MACTANLY PL STE E
Practice Address - Street 2:
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-2316
Practice Address - Country:US
Practice Address - Phone:540-886-3063
Practice Address - Fax:540-886-6246
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001694103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical