Individual
MINDY LICCIARDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT
Contact information
Practice address
773 WOOD DUCK LN, SLIDELL, LA 70461-1680
(504) 512-4270
Mailing address
773 WOOD DUCK LN, SLIDELL, LA 70461-1680
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTT.200029
LA
Other
Enumeration date
08/07/2021
Last updated
08/07/2021
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