Individual
LEANNE LICITRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 HOBOKEN AVE, JERSEY CITY, NJ 07310-1028
(973) 897-9397
Mailing address
26 MANDEVILLE AVE, PEQUANNOCK, NJ 07440-1538
(973) 897-9397
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
11/14/2022
Last updated
11/14/2022
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