Individual
JANE LICATOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSCCCSLP
Contact information
Practice address
500 PHILADELPHIA AVE, SHILLINGTON, PA 19607-2764
(610) 796-7022
Mailing address
217 E 1ST ST FL 3E, BIRDSBORO, PA 19508-2375
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL005351L
PA
Other
Enumeration date
06/24/2009
Last updated
06/24/2009
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