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MS. LUCILLE IDAROLA CCC-SLP

>> Speech-Language Pathologist >> Speech, Language and Hearing Service Providers

Registrant NPI Number: 1215123260

Individual Registrant:
MS. LUCILLE  IDAROLA CCC-SLP
Gender: F
Sole Proprietor

Location and contact information for practice:
2495 SW CENTERVILLE AVE  FORT WHITE, FL 32038-6110 US
Tel: 352-339-5753  Fax: --

Contact information for business:
2495 SW CENTERVILLE AVE  FORT WHITE, FL 32038-6110 US
Tel: 352-339-5753  Fax: --

Registration Information:
NPI: 1215123260
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y235Z00000XSpeech, Language and Hearing Service Providers
Speech-Language Pathologist
FLSA6006

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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