ANTHONY LICEA

JAMAICA, NY
NPI1750255055
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NY  39318-T)
Enumeration Date2025-10-01
Last Update Date2025-10-01
Business Address
ANTHONY LICEA
9002 161ST ST
JAMAICA, NY 11432-6108
Phone number: 718-520-1513
Mailing Address
ANTHONY LICEA
79 GLENRIDGE RD
GLENVILLE, NY 12302-4523
Phone number: