Individual
LOURDES LICUANAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
5606 SHIELDS DR, BETHESDA, MD 20817-3571
(301) 493-0023
Mailing address
2500 Q ST NW, WASHINGTON, DC 20007-4373
(864) 230-0468
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT010000606
DC
Other
Enumeration date
11/25/2014
Last updated
11/25/2014
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