Individual provider · Type 1 NPI
Yvonne Licavoli
Professional Counselor · Swansea, IL
NPI number
1760113005
Active
Practice location
4509 N Illinois St Ste 4
Swansea, IL 62226-1524
Mailing address
9626 Ridge Heights Rd
Fairview Heights, IL 62208-2319
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | 178015261 (IL) |
Professional Counselor: Definition to come...
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About NPI 1760113005
Yvonne Licavoli's National Provider Identifier is 1760113005, issued on Jun 17, 2022. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Swansea, IL. The record was last updated on Jun 17, 2022.