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1952667024
STEPHANIE ELISE LICONA
MIAMI, FL
NPI
1952667024
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
Enumeration Date
2012-04-03
Last Update Date
2018-05-24
Business Address
STEPHANIE ELISE LICONA
1201 NW 16TH ST
MIAMI, FL 33125
Phone number: 305-575-3148
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Mailing Address
STEPHANIE ELISE LICONA
1201 NW 16TH ST
MIAMI, FL 33125-1624
Phone number: 305-575-3148
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