| NPI | 1104151406 |
|---|---|
| Former Name | KAREN BETH LICSKEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: WI 2237026) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: IL 056008379) |
| Enumeration Date | 2009-10-05 |
| Last Update Date | 2009-10-05 |