MICHAEL MICKELSON

CHEYENNE, WY
NPI1780928093
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker Clinical
(Licence: WY  LCSW1145)
Enumeration Date2012-11-27
Last Update Date2020-04-27
Business Address
MICHAEL MICKELSON LCSW
2360 E PERSHING BLVD
CHEYENNE, WY 82001-5356
Phone number: 307-778-7550
Mailing Address
MICHAEL MICKELSON LCSW
2360 E PERSHING BLVD
CHEYENNE, WY 82001-5356
Phone number: 307-778-7550
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