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Individual
JANIS MIKKELSEN
Active
Individual
JANIS MIKKELSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
103T00000X
Psychologist
SS1138
FL
Other
Enumeration date
03/10/2015
Last updated
11/01/2016
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