Individual
ANNA C. LICAVOLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LLMSW
Contact information
Practice address
24445 NORTHWESTERN HWY STE 200, SOUTHFIELD, MI 48075-2437
(248) 850-1998
Mailing address
1951 KENMORE DR, GROSSE POINTE WOODS, MI 48236-1931
(248) 635-3921
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6851093398
MI
Other
Enumeration date
10/20/2011
Last updated
01/05/2024
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