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1104074376
KYLE DAVID MICKEY
AURORA, CO
NPI
1104074376
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2008-08-30
Last Update Date
2008-08-30
Business Address
Mr. KYLE DAVID MICKEY
1455 BEELER ST
AURORA, CO 80010-3027
Phone number: 303-360-6014
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Mailing Address
Mr. KYLE DAVID MICKEY
11111 ALCOTT ST APT A
WESTMINSTER, CO 80234-3180
Phone number: 303-506-8116
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