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1992103451
SEAN ALEXANDER MICKELSON
SALEM, OR
NPI
1992103451
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor Professional
(Licence: OR C6214)
Enumeration Date
2014-12-16
Last Update Date
2021-06-15
Business Address
SEAN ALEXANDER MICKELSON MS, LPC
1515 LIBERTY ST SE
SALEM, OR 97302-4345
Phone number: 503-951-6280
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Mailing Address
SEAN ALEXANDER MICKELSON MS, LPC
1515 LIBERTY ST SE
SALEM, OR 97302-4345
Phone number: 503-951-6280
Copy
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