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Joanna O Licon
Peer Specialist in Kennewick, Washington
NPI 1184192403

Joanna O Licon is a Peer Specialist based in Kennewick, WA. Joanna O Licon practices in Kennewick, WA. The NPI Number for Joanna O Licon is 1184192403 and holds a License No. (Washington).

The current practice location address for Joanna O Licon is 3321 W Kennewick Ave Ste 150, Kennewick, WA and can be reached out via phone at 509-735-6446.

Location: 3321 W Kennewick Ave Ste 150, Kennewick, WA, 99336-2968
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1184192403
Provider Name
Joanna O Licon
Credential
Provider Entity Type
Individual
Gender
Female
Address
3321 W Kennewick Ave Ste 150, Kennewick, WA, 99336-2968
Phone Number
509-735-6446
Fax Number
Provider Enumeration Date
11/05/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
3321 W Kennewick Ave Ste 150
City
Kennewick
State
Washington
Zip
99336-2968
Phone Number
509-735-6446
Fax Number
person
Provider Business Mailing Address Details
Address
3321 W Kennewick Ave Ste 150
City
Kennewick
State
Washington
Zip
99336-2968
Phone Number
509-735-6446
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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