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Individual
NATALIE NICOLE MIKKELSON
Active
Individual
NATALIE NICOLE MIKKELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP/CCC
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA11318
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002313000
—
FL
01
—
Y911W
BLUE CROSS BLUE SHIELD
FL
Enumeration date
07/21/2010
Last updated
08/29/2019
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