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MS. LUCILLE IDAROLA CCC-SLP
>> Speech-Language Pathologist >> Speech, Language and Hearing Service ProvidersRegistrant NPI Number: 1215123260
Individual Registrant:MS. LUCILLE IDAROLA CCC-SLP
Gender: F
Sole Proprietor
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: --
Tel: 352-339-5753 Fax: --
Contact information for business:
2495 SW CENTERVILLE AVE FORT WHITE, FL 32038-6110 US
Tel: 352-339-5753 Fax: --
Tel: 352-339-5753 Fax: --
Registration Information:
NPI: 1215123260
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 235Z00000X | Speech, Language and Hearing Service Providers Speech-Language Pathologist | FL | SA6006 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
