MS. Ana D Licano, LMP
NPI #1104057595 in Grandview, Washington
Provider Information
- NPI Number
- 1104057595
- Entity Type
- Individual
- Name
- MS. Ana D Licano, LMP
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Massage Therapist
- Credential
- LMP
- Enumeration Date
- Aug 3, 2009
- Last Updated
- Aug 3, 2009
Practice Location
- Address
- 310 DIVISION ST
- City
- Grandview
- State
- Washington
- ZIP Code
- 98930-1359
- Phone
- (509) 882-3659
Specialties & Taxonomy Codes
| Specialty |
|---|
| Massage Therapist |
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