Provider Demographics
NPI:1265780050
Name:CICCONI, ASHLEIGH LORRIN (MT-BC)
Entity type:Individual
Prefix:DR
First Name:ASHLEIGH
Middle Name:LORRIN
Last Name:CICCONI
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:ASHLEIGH
Other - Middle Name:LORRIN
Other - Last Name:BELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5100 BUCKEYSTOWN PIKE STE 250
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21704-8344
Mailing Address - Country:US
Mailing Address - Phone:410-417-7556
Mailing Address - Fax:
Practice Address - Street 1:114 FALLSTON MEADOW CT
Practice Address - Street 2:
Practice Address - City:FALLSTON
Practice Address - State:MD
Practice Address - Zip Code:21047-2543
Practice Address - Country:US
Practice Address - Phone:480-347-5233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-27
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00009225A00000X
FL225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist