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1710741343
DOMINIQUE JALISIA MICKLER
ST PETERSBURG, FL
NPI
1710741343
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: FL SW22641)
Enumeration Date
2024-02-13
Last Update Date
2024-02-13
Business Address
DOMINIQUE JALISIA MICKLER LCSW
360 CENTRAL AVE STE 1230
ST PETERSBURG, FL 33701-3865
Phone number: 172-756-5242
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Mailing Address
DOMINIQUE JALISIA MICKLER LCSW
706 12TH ST E
BRADENTON, FL 34208-2120
Phone number: 941-920-8436
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