Provider Demographics
NPI:1922528892
Name:FIOCCA, ELIZABETH T
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:T
Last Name:FIOCCA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1819 HILLSIDE TER
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44305-2806
Mailing Address - Country:US
Mailing Address - Phone:440-463-7223
Mailing Address - Fax:
Practice Address - Street 1:155 N WATER ST
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-2418
Practice Address - Country:US
Practice Address - Phone:330-678-3006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-22
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1500603101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty