Individual
TAYLOR LICKTEIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
65 E UNIVERSITY DR, TEMPE, AZ 85281-1091
(803) 176-1834
Mailing address
7621 N VIA DEL ELEMENTAL, SCOTTSDALE, AZ 85258-3563
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-046862
AZ
Other
Enumeration date
06/29/2023
Last updated
06/29/2023
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