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NPI Code Detail

MEDICARE: GABRIELA CICCONETTI QMHS-BACH

MEDICARE: GABRIELA CICCONETTI QMHS-BACH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1154111383
Entity Type Code : Individual
Provider Name (Legal Business Name) : GABRIELA CICCONETTI QMHS-BACH
Provider Business Mailing Address
First Line : 2285 BENDEN DR
Second Line :
City : WOOSTER
State : OH
Zip : 44691-2568
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2285 BENDEN DR
Second Line :
City : WOOSTER
State : OH
Zip : 44691-2568
Country : US
Telephone Number : 330-264-9029
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2025
Last Update Date : 05/13/2026

Similar Medicare Providers

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Practice Location Address:
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1386461820 — KELSEY HUBERTY MSW, LSW
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1639812548 — JENNIFER GARCIA PRS, QMHS-HS
Practice Location Address:
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1083297659 — BRITTANY MARIE PHILLIPS MSW, LSW
Practice Location Address:
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Practice Fax: 330-263-7251

Directions to “ GABRIELA CICCONETTI QMHS-BACH” Practice Location

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