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Organization
TARGETED NEUROFEEDBACK AND PSYCHOTHERAPY SERVICES, PLLC
Active
Organization
TARGETED NEUROFEEDBACK AND PSYCHOTHERAPY SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC C MIKELAIT LMSW (OWNER)
(517) 740-6239
Entity
Organization
Contact information
Practice address
915 AIRPORT RD, JACKSON, MI 49202-1850
(517) 740-6239
Mailing address
3008 S WOODDALE DR, JACKSON, MI 49203-3767
(517) 740-6239
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
E27191
MI
Other
Enumeration date
09/20/2013
Last updated
10/01/2015
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