Provider Demographics
NPI:1801919428
Name:CIRKA, NANCY ANN (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:ANN
Last Name:CIRKA
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:ANN
Other - Last Name:MANOCK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:179 CANDLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-1623
Mailing Address - Country:US
Mailing Address - Phone:401-886-5545
Mailing Address - Fax:
Practice Address - Street 1:179 CANDLEWOOD DR
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-1623
Practice Address - Country:US
Practice Address - Phone:401-886-5545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RISPOO282235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist