Healthcare Provider Details

I. General information

NPI: 1487585105
Provider Name (Legal Business Name): ALLISON L CICALESE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26822 LEWES GEORGETOWN HWY
HARBESON DE
19951-2856
US

IV. Provider business mailing address

23598 HARVEST RUN REACH
MILTON DE
19968-2469
US

V. Phone/Fax

Practice location:
  • Phone: 302-827-7447
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT-0015411
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: