Individual
MR. JOSEPH BAISDEN MICKLER III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
110 EVANS MILL DR, #305, DALLAS, GA 30157-1622
(770) 445-6358
(770) 445-7262
Mailing address
3094 NOAH CT, ACWORTH, GA 30101-6258
(770) 851-7988
(678) 574-9585
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC003204
GA
Other
Enumeration date
01/11/2007
Last updated
07/09/2007
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