William Burton Cicalo, OTR/L
Occupational Therapist in Saint Clair Shores, MI. Individual provider (NPI-1).
NPI number1720618713
StatusActive
Last updated in NPPESJan 19, 2020
Details
- NPI
- 1720618713
- Entity type
- Individual (NPI-1)
- Name
- William Burton Cicalo
- Credential
- OTR/L
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 19, 2020
- Certification date
- Jan 19, 2020
- Last updated
- Jan 19, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225X00000X | Occupational Therapist | 5201008223 | MI | Yes |
Practice location
26001 Jefferson AveSaint Clair Shores, MI 48081-2309
Phone 586-779-7000
Mailing address
18201 Whitmore DrClinton Township, MI 48035-5027
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