Individual
MRS. PATRICIA LICAUSI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3148 MAIN STREET, FREDERICA, DE 19946
(302) 724-9113
Mailing address
3148 MAIN ST., FREDERICA, DE 19946
(302) 538-4183
(302) 724-9113
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/27/2016
Last updated
01/27/2016
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