Individual
MS. ELISHIA LICAVOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.R.L.
Contact information
Practice address
3707 KATALIN COURT, BAY CITY, MI 48706-2161
(989) 671-0866
(989) 671-0867
Mailing address
3707 KATALIN COURT, BAY CITY, MI 48706-2161
(989) 671-0866
(989) 671-0867
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
08/02/2011
Last updated
08/02/2011
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