Doctor Name: | LORI M LICKER |
NPI Number: | 1124336680 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | OTR |
License Number: | 2506 |
Business Practice Address: | 150 Maya Cir Central Islip, NY - 117224542 |
Business Phone Number: | 6317306401 |
Business Fax Number: | |
Mailing Address: | 150 Maya Cir, CENTRAL ISLIP |
State: | NY |
Postal Code: | 117224542 |
Phone Number: | 6317306401 |
Fax Number: | |
NPI Enumeration Date: | 09/18/2010 |
NPI Last Update Date: | 09/18/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251300000X |
License Number: | 2506 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Local Education Agency (LEA) |
Taxonomy Specialization: | |
Taxonomy Definition: | The term local education agency means a public board of education or other public authority legally constituted within a State to either provide administrative control or direction of, or perform a service function for public schools serving individuals ages 0 |