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Individual

MR. ALBERT MICKENS JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BS

Contact information

Practice address
209 LITHIA PINECREST RD, BRANDON, FL 33511-5307
(813) 370-8005
Mailing address
453 STONE BRIAR DR, RUSKIN, FL 33570-3221

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Enumeration date
03/16/2018
Last updated
03/16/2018
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