Individual
ENRIQUE LICONA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, SUDPT
Contact information
Practice address
120 S 3RD ST, YAKIMA, WA 98901-2875
(509) 865-6705
Mailing address
90 ORCHARDVALE RD, ZILLAH, WA 98953-9021
(509) 790-8016
(509) 790-8016
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
61681564
WA
Other
Enumeration date
05/19/2025
Last updated
05/19/2025
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