Individual
SAMANTHA LICHOCKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5447 WOODWARD AVE, DETROIT, MI 48202-4009
(313) 832-1100
Mailing address
19276 GOLD RIVER DR, MACOMB, MI 48044-4251
(630) 631-7954
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
09/28/2010
Last updated
09/28/2010
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