Provider Demographics
NPI:1891924460
Name:CIRRICIONE, LAURA BETH (MS)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:BETH
Last Name:CIRRICIONE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1340 W INDIAN TRL APT 1
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-6019
Mailing Address - Country:US
Mailing Address - Phone:815-212-2601
Mailing Address - Fax:
Practice Address - Street 1:1340 W INDIAN TRL APT 1
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-6019
Practice Address - Country:US
Practice Address - Phone:815-212-2601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-04
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242.001105235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist