Individual
MARGARET S. LICAVOLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
123 WEAVER RD STE B, BLAIRSVILLE, GA 30512-3155
(170) 643-9648
Mailing address
351 E HIGHLAND ST, BLUE RIDGE, GA 30513-4544
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
RN168368
GA
Other
Enumeration date
05/04/2022
Last updated
08/17/2022
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