Individual
JALICSA GEMAHI LICERIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
7660 TIMBER CIR, TYLER, TX 75708-5823
(903) 279-9381
Mailing address
7660 TIMBER CIR, TYLER, TX 75708-5823
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
341323
TX
Other
Enumeration date
01/14/2020
Last updated
01/14/2020
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