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Individual

MRS. ALYSSA ANN LICHON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
945 BARLOW ST, TRAVERSE CITY, MI 49686-4250
(231) 268-0007
Mailing address
PO BOX 1078, KALKASKA, MI 49646-1078
(231) 492-5489

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
03/10/2022
Last updated
03/10/2022
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