Individual
DANALIZ LICEAGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1020 E OSCEOLA PKWY, KISSIMMEE, FL 34744-1607
(407) 201-2912
Mailing address
2007 S 58TH ST, TAMPA, FL 33619-5309
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SI3389
FL
Other
Enumeration date
10/24/2017
Last updated
10/24/2017
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