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1265594345
MARY LANE MICKENS
TEXARKANA, TX
NPI
1265594345
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Professional Name
MARY SMITH MICKENS
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: TX 19530)
Enumeration Date
2006-12-14
Last Update Date
2007-07-08
Business Address
Mrs. MARY LANE MICKENS
5221 N PARK RD
TEXARKANA, TX 75503-2664
Phone number: 903-791-1051
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Mailing Address
Mrs. MARY LANE MICKENS
30 SHERRY RDG
TEXARKANA, TX 75501-2040
Phone number: 903-277-4887
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