Provider Demographics
NPI:1851179949
Name:CISCELL, GILLIAN
Entity type:Individual
Prefix:
First Name:GILLIAN
Middle Name:
Last Name:CISCELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12871 RAWLINGS PL
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-8392
Mailing Address - Country:US
Mailing Address - Phone:317-760-3848
Mailing Address - Fax:
Practice Address - Street 1:10294 E 96TH ST
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-9497
Practice Address - Country:US
Practice Address - Phone:317-288-7572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist