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1710510136
JEANIE MICKELSEN
CHAMPAIGN, IL
NPI
1710510136
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
104100000X Social Worker
Enumeration Date
2020-02-13
Last Update Date
2020-02-13
Business Address
JEANIE MICKELSEN LCPC
1802 S MATTIS AVE
CHAMPAIGN, IL 61821-5923
Phone number: 217-383-1850
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Mailing Address
JEANIE MICKELSEN LCPC
611 W. PARK ST. FAPC
URBANA, IL 61801
Phone number:
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