Individual
CHRISTINE LICCIARDELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
12 BROOK PLACE, BLOOMFIELD, NJ 07003-0700
(973) 303-2112
Mailing address
12 BROOK PLACE, BLOOMFIELD, NJ 07003
(973) 303-2112
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18KT00993300
NJ
Other
Enumeration date
07/29/2021
Last updated
07/29/2021
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