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Individual

EMILY LIDDICOAT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
2312 SNELLING AVE, MINNEAPOLIS, MN 55404-3157
(612) 874-6409
(612) 874-0157
Mailing address
625 W WASHINGTON AVE, MADISON, WI 53703-2637
(608) 280-2700

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
128838-121
WI

Other

Enumeration date
10/25/2012
Last updated
03/06/2019
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