Provider Demographics
NPI:1881415073
Name:CIOCCA, KELSIE ROSE (CNTP)
Entity type:Individual
Prefix:
First Name:KELSIE
Middle Name:ROSE
Last Name:CIOCCA
Suffix:
Gender:F
Credentials:CNTP
Other - Prefix:
Other - First Name:KELSIE
Other - Middle Name:ROSE
Other - Last Name:CHRISTIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNTP
Mailing Address - Street 1:1205 CRESTVIEW RD
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:IL
Mailing Address - Zip Code:61081-4313
Mailing Address - Country:US
Mailing Address - Phone:815-213-0240
Mailing Address - Fax:
Practice Address - Street 1:1205 CRESTVIEW RD
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:IL
Practice Address - Zip Code:61081-4313
Practice Address - Country:US
Practice Address - Phone:815-213-0240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach