Provider Demographics
NPI:1144009416
Name:ZICCARDI, NATALIE CLAIRE (MA SLP)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:CLAIRE
Last Name:ZICCARDI
Suffix:
Gender:F
Credentials:MA SLP
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:CLAIRE
Other - Last Name:DIXON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA SLP
Mailing Address - Street 1:270 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-4312
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:270 E STATE ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-4312
Practice Address - Country:US
Practice Address - Phone:614-365-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-26
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.15655235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist