Provider Demographics
NPI:1548421761
Name:LO CICERO, CECILIA (BS CBRS ITFS)
Entity type:Individual
Prefix:MRS
First Name:CECILIA
Middle Name:
Last Name:LO CICERO
Suffix:
Gender:F
Credentials:BS CBRS ITFS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6021 LARBOARD DR
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27539-4115
Mailing Address - Country:US
Mailing Address - Phone:919-449-8163
Mailing Address - Fax:
Practice Address - Street 1:6021 LARBOARD DR
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27539-4115
Practice Address - Country:US
Practice Address - Phone:919-449-8163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-20
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist