Individual
ELISE CHRISTINE LICKTEIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3229 S CHEROKEE LN STE 1400, WOODSTOCK, GA 30188-4461
(470) 499-2480
Mailing address
7500 SAN FELIPE ST STE 990, HOUSTON, TX 77063-1708
(866) 610-0580
(866) 611-1558
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/26/2024
Last updated
07/26/2024
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