Provider Demographics
NPI:1649328881
Name:CIESLA, CARA JEANNE (AUD)
Entity type:Individual
Prefix:MS
First Name:CARA
Middle Name:JEANNE
Last Name:CIESLA
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 ROUND HILL RD
Mailing Address - Street 2:
Mailing Address - City:NAUGATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06770-1618
Mailing Address - Country:US
Mailing Address - Phone:203-729-4962
Mailing Address - Fax:
Practice Address - Street 1:98 YORK ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-5602
Practice Address - Country:US
Practice Address - Phone:203-865-2341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT242231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist