# MS. MELINDA RAQUEL MICKELSEN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1720235690
- **Gender:** F
- **Credential:** MS, ORT/L

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225X00000X | Occupational Therapist | 31004140A | IN | — |
| 225X00000X | Occupational Therapist | KY-R1598 | KY | Yes |

## Other

- **Enumeration date:** 08/22/2008
- **Last updated:** 08/22/2008