Allyson Leigh Licese

NPI #1033686514 in Middletown, Connecticut

Provider Information

NPI Number: 1033686514
Entity Type: Individual
Name: Allyson Leigh Licese
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor
Enumeration Date: Nov 1, 2018
Last Updated: Oct 26, 2020

Practice Location

Address: 28 RUSSETT LN
City: Middletown
State: Connecticut
ZIP Code: 06457-5803
Phone: (203) 206-3538

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X
Counselor	101Y00000X	Primary

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