Healthcare Provider Details

I. General information

NPI: 1588097539
Provider Name (Legal Business Name): ANNA CIFELLI MA, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2013
Last Update Date: 08/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4411 TREVI CT APT. 203
LAKE WORTH FL
33467-4212
US

IV. Provider business mailing address

4411 TREVI CT APT. 203
LAKE WORTH FL
33467-4212
US

V. Phone/Fax

Practice location:
  • Phone: 862-215-6173
  • Fax:
Mailing address:
  • Phone: 862-215-6173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA 12254
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number41YS00706700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: