DANIEL MICKELSON

JANESVILLE, WI
NPI1750184669
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI  20656-130)
Enumeration Date2025-03-28
Last Update Date2025-05-06
Business Address
DANIEL MICKELSON SAC-IT
903 MINERAL POINT AVE
JANESVILLE, WI 53548-2970
Phone number: 608-756-6564
Mailing Address
DANIEL MICKELSON SAC-IT
718 WALKER WAY
EDGERTON, WI 53534-1700
Phone number:
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