JUSTIN RANDAL MICKEY

PHOENIX, AZ
NPI1932467727
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: AZ  TAP4472)
Enumeration Date2012-04-30
Last Update Date2012-04-30
Business Address
-- JUSTIN RANDAL MICKEY PMHNP
2500 E VAN BUREN ST
PHOENIX, AZ 85008-6037
Phone number: 602-220-6078
Mailing Address
-- JUSTIN RANDAL MICKEY PMHNP
3420 E CLARENDON AVE
PHOENIX, AZ 85018-5758
Phone number: 480-532-7765
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