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Individual
KATELYN ANN MICKELSON
Active
Individual
KATELYN ANN MICKELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
609P
ND
103T00000X
Psychologist
Primary
622
ND
103TC0700X
Clinical Psychologist
LP6215
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
NULL
Other
Enumeration date
06/29/2015
Last updated
05/22/2025
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