Individual
DOLLEEN LICCIARDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
141 ORMOND CENTER CT, DESTREHAN, LA 70047-2548
(985) 764-7337
(985) 764-5333
Mailing address
298 HENRY CLAY AVE, NEW ORLEANS, LA 70118-5720
(504) 896-9827
(504) 894-5370
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
17300
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1364045
—
LA
Enumeration date
06/09/2005
Last updated
01/07/2011
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