Dominick Licata

NPI #1073213211 in Sugarloaf, Pennsylvania

Provider Information

NPI Number: 1073213211
Entity Type: Individual
Name: Dominick Licata
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Mar 7, 2023
Last Updated: Mar 7, 2023

Practice Location

Address: 1 BROOKHILL SQ S
City: Sugarloaf
State: Pennsylvania
ZIP Code: 18249-1016
Phone: (888) 726-4774

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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