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1053808006
MARISA CATHERINE MICKUNAS
DES MOINES, IA
NPI
1053808006
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: IA 090226)
Enumeration Date
2018-04-16
Last Update Date
2018-04-16
Business Address
MARISA CATHERINE MICKUNAS MS CRC
1301 CENTER ST
DES MOINES, IA 50309-1004
Phone number: 515-243-2760
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Mailing Address
MARISA CATHERINE MICKUNAS MS CRC
1612 31ST ST
DES MOINES, IA 50311-2810
Phone number: 515-402-3799
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