Provider Demographics
NPI:1548895345
Name:DICAPO, CHRISTOPHER F
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:F
Last Name:DICAPO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8405 LOBELIA CT
Mailing Address - Street 2:
Mailing Address - City:SHAKOPEE
Mailing Address - State:MN
Mailing Address - Zip Code:55379-3159
Mailing Address - Country:US
Mailing Address - Phone:612-741-4672
Mailing Address - Fax:
Practice Address - Street 1:8405 LOBELIA CT
Practice Address - Street 2:
Practice Address - City:SHAKOPEE
Practice Address - State:MN
Practice Address - Zip Code:55379-3159
Practice Address - Country:US
Practice Address - Phone:612-741-4672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-12
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2691237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist