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1225855281
ELISE LICON
ORANGE, CA
NPI
1225855281
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: CA 148419)
Enumeration Date
2024-09-23
Last Update Date
2024-09-23
Business Address
ELISE LICON
1100 W TOWN AND COUNTRY RD STE 1250
ORANGE, CA 92868-4633
Phone number: 657-339-2799
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Mailing Address
ELISE LICON
PO BOX 236
LOS ALAMITOS, CA 90720-0236
Phone number: 714-726-0450
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