MRS. JENNIFER RENEE DICICCO DPT
NPI 1255584330
Physical Therapist - Pediatrics in Charlotte, NC

Q: What is the provider's specialty?

The provider's specialty is Physical Therapist with taxonomy code 2251P0200X and a focus in Pediatrics.

Active since November 03, 2008

4501 CAMERON VALLEY PKWY, SUITE 300, CHARLOTTE, NC 28211(703) 304-0620(704) 304-0620 Get Directions Write a Review

NPPES record last updated: November 5, 2012. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Mrs. Jennifer Renee Dicicco Dpt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. JENNIFER RENEE DICICCO DPT (NPI 1255584330) is an individual pediatrics provider in Charlotte, North Carolina, licensed in North Carolina (P12753) and active in the NPI registry since November 2008.

NPPES Registry Identity

NPI1255584330

Entity TypeIndividualFemale

Primary Taxonomy2251P0200X

Provider Legal NameMRS. JENNIFER RENEE DICICCOCredential: DPT

Location Address4501 CAMERON VALLEY PKWY, SUITE 300Charlotte, NC 28211-4297

Mailing Address1100 Blythe BlvdCharlotte, NC 28203-5814 · (704) 304-0620 · Fax (704) 304-0621

Phone(703) 304-0620

Fax(704) 304-0620

Sole ProprietorNo

Enumeration DateNovember 3, 2008

Last NPPES UpdateNovember 5, 2012

✔ NPI 1255584330 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysical Therapist · PediatricsRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy Code2251P0200X

License✔ Licensed in NC · P12753

Definition

A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Pediatric Physical Therapy, who has demonstrated specialized knowledge and skill in anatomy, histology, including embryonic development, genetics, biomechanics, neurological function, neuroscience, and pathology, behavioral sciences, and understanding of diseases or conditions that necessitate physical therapy care, that affect systems that in turn necessitate physical therapy care (comorbidities), and that influence the type of intervention that can be given.

Also ListedPhysical TherapistTaxonomy 225100000X · License 2305205704 (VA)

4501 CAMERON VALLEY PKWY, Charlotte, NC 28211

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