Individual
DIANDRA LICCARDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
333 NAPLES DR, ELYRIA, OH 44035-1524
(440) 324-1168
Mailing address
5445 SMITH RD, BROOKPARK, OH 44142-2026
(216) 332-9360
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
11/15/2024
Last updated
11/15/2024
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