Individual
CLARICE LICON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
3174 THORNAPPLE DR, LANCASTER, PA 17601-6906
(717) 471-8244
Mailing address
3174 THORNAPPLE DR, LANCASTER, PA 17601-6906
(717) 471-8244
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC014912
PA
Other
Enumeration date
01/30/2017
Last updated
01/30/2017
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