NPI | 1104474410 |
---|---|
Professional Name | STEPHANIE A NISLE-MIKOS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CO LPC.0017134) |
Additional Taxonomies | 101YM0800X Counselor Mental Health |
Enumeration Date | 2019-08-29 |
Last Update Date | 2022-09-21 |