Provider Demographics
NPI:1427632058
Name:CICALESE, ASHLEY BRIELLE
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:BRIELLE
Last Name:CICALESE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:BRIELLE
Other - Last Name:HUGHES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:138 GOLF CLUB DR
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-2161
Mailing Address - Country:US
Mailing Address - Phone:267-274-8067
Mailing Address - Fax:
Practice Address - Street 1:138 GOLF CLUB DR
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-2161
Practice Address - Country:US
Practice Address - Phone:267-274-8067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-10
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA390200000X
PASL016292235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program