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1194218123
ANTHONY (MIA) JOEL MIKELIC
PRINEVILLE, OR
NPI
1194218123
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2018-06-13
Last Update Date
2018-06-13
Business Address
ANTHONY (MIA) JOEL MIKELIC
1103 NE ELM ST
PRINEVILLE, OR 97754-1664
Phone number: 541-323-5330
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Mailing Address
ANTHONY (MIA) JOEL MIKELIC
934 NE DEL RIO AVE
PRINEVILLE, OR 97754-1364
Phone number: 541-362-6979
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