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1780928093
MICHAEL MICKELSON
CHEYENNE, WY
NPI
1780928093
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: WY lcsw1145)
Enumeration Date
2012-11-27
Last Update Date
2020-04-27
Business Address
MICHAEL MICKELSON LCSW
2360 E PERSHING BLVD
CHEYENNE, WY 82001-5356
Phone number: 307-778-7550
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Mailing Address
MICHAEL MICKELSON LCSW
2360 E PERSHING BLVD
CHEYENNE, WY 82001-5356
Phone number: 307-778-7550
Copy
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