Individual
MRS. JENNIFER LICATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
6242 HAMMOCK PARK RD, WEST PALM BEACH, FL 33411-6456
(561) 640-2920
Mailing address
6242 HAMMOCK PARK RD, WEST PALM BEACH, FL 33411-6456
(561) 640-2920
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
OT10827
FL
225X00000X
Occupational Therapist
OT10827
FL
Other
Enumeration date
01/31/2008
Last updated
09/25/2012
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