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Individual
KELLY RADFORD LICQUIA
Active
Individual
KELLY RADFORD LICQUIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA13231
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012952300
—
FL
05
—
013610500
—
FL
05
—
7412328
—
NC
Enumeration date
12/22/2006
Last updated
11/02/2023
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