# MICHAELA KATHRYN MABRY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1063046142
- **Gender:** F
- **Credential:** LCSW

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 104100000X | Social Worker | 2020002806 | MO | — |
| 104100000X | Social Worker | I.2405214 | OH | Yes |
| 1041C0700X | Clinical Social Worker | 2022020458 | MO | — |

## Other

- **Enumeration date:** 02/27/2020
- **Last updated:** 08/08/2024