Individual
WILLIAM THOMAS LICKISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13947 S NEWBURG DR, HERRIMAN, UT 84096-6787
(801) 506-6695
Mailing address
13947 S NEWBURG DR, HERRIMAN, UT 84096-6787
(801) 506-6695
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
14060937-2506
UT
172V00000X
Community Health Worker
—
—
Other
Enumeration date
09/21/2018
Last updated
08/05/2024
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