Individual
MARISA CATHERINE MICKUNAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CRC
Contact information
Practice address
1301 CENTER ST, DES MOINES, IA 50309-1004
(515) 243-2760
(515) 243-2760
Mailing address
1612 31ST ST, DES MOINES, IA 50311-2810
(515) 402-3799
(515) 243-2760
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
090226
IA
Other
Enumeration date
04/16/2018
Last updated
04/16/2018
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