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1265175962
KASSANDRA ALEXIS MICKELSON
STOCKTON, CA
NPI
1265175962
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2022-04-19
Last Update Date
2022-04-19
Business Address
KASSANDRA ALEXIS MICKELSON
1811 GRAND CANAL BLVD STE 2
STOCKTON, CA 95207-8107
Phone number: 530-721-9074
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Mailing Address
KASSANDRA ALEXIS MICKELSON
2837 MOULTON DR
PLACERVILLE, CA 95667-4333
Phone number: 530-721-9074
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