Provider Demographics
NPI:1881859445
Name:CICALO, JANEL (MA,, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:JANEL
Middle Name:
Last Name:CICALO
Suffix:
Gender:F
Credentials:MA,, CCC-SLP
Other - Prefix:MS
Other - First Name:JANEL
Other - Middle Name:
Other - Last Name:CICALO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MACCC-SLP
Mailing Address - Street 1:33353 REGAL
Mailing Address - Street 2:
Mailing Address - City:FRASER
Mailing Address - State:MI
Mailing Address - Zip Code:48026-1757
Mailing Address - Country:US
Mailing Address - Phone:586-296-2816
Mailing Address - Fax:
Practice Address - Street 1:35746 HARPER AVE
Practice Address - Street 2:
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48035-3212
Practice Address - Country:US
Practice Address - Phone:586-791-9203
Practice Address - Fax:586-791-9204
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist