Provider Demographics
NPI:1205537032
Name:BICAKCI, SELDA
Entity type:Individual
Prefix:
First Name:SELDA
Middle Name:
Last Name:BICAKCI
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 1:33 UTICA DR, WORCESTER, MA 01603
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01603-1504
Mailing Address - Country:US
Mailing Address - Phone:617-855-1954
Mailing Address - Fax:
Practice Address - Street 1:28 SHERI LN
Practice Address - Street 2:
Practice Address - City:AGAWAM
Practice Address - State:MA
Practice Address - Zip Code:01001-1504
Practice Address - Country:US
Practice Address - Phone:860-333-2751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-17
Last Update Date:2023-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician