Provider Demographics
NPI:1871100461
Name:LACEY, CECILIA MERCEDES (AUD)
Entity type:Individual
Prefix:DR
First Name:CECILIA
Middle Name:MERCEDES
Last Name:LACEY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5823 GLEN HILL DR
Mailing Address - Street 2:
Mailing Address - City:BETHEL PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15102-2431
Mailing Address - Country:US
Mailing Address - Phone:412-304-1202
Mailing Address - Fax:
Practice Address - Street 1:5823 GLEN HILL DR
Practice Address - Street 2:
Practice Address - City:BETHEL PARK
Practice Address - State:PA
Practice Address - Zip Code:15102-2431
Practice Address - Country:US
Practice Address - Phone:412-304-1202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-28
Last Update Date:2023-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT006886231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist