Individual
CARLY ANN LICAMELI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
108 CONOVER AVE, NUTLEY, NJ 07110-3398
(973) 204-8045
Mailing address
108 CONOVER AVE, NUTLEY, NJ 07110-3398
(973) 204-8045
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
14094243
NJ
Other
Enumeration date
07/07/2017
Last updated
07/21/2022
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