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1093557050
ANNETTE LICKWOLA
NEW LONDON, CT
NPI
1093557050
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CT 44.001570)
Enumeration Date
2024-06-11
Last Update Date
2024-10-31
Business Address
Mrs. ANNETTE LICKWOLA LADC
931 BANK ST
NEW LONDON, CT 06320-2702
Phone number: 860-574-8256
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Mailing Address
Mrs. ANNETTE LICKWOLA LADC
931 BANK ST
NEW LONDON, CT 06320-2702
Phone number: 860-574-8256
Copy
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