STEPHANIE ELISE LICONA

MIAMI, FL
NPI1952667024
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy235Z00000X Speech-Language Pathologist,
Enumeration Date2012-04-03
Last Update Date2018-05-24
Business Address
STEPHANIE ELISE LICONA
1201 NW 16TH ST
MIAMI, FL 33125
Phone number: 305-575-3148
Mailing Address
STEPHANIE ELISE LICONA
1201 NW 16TH ST
MIAMI, FL 33125-1624
Phone number: 305-575-3148