Individual
GREGORY A MICKLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3029 MARTIN LUTHER KING JR AVE SE, WASHINGTON, DC 20032-2506
(202) 232-6100
(202) 610-9507
Mailing address
2234 HUNTER PLACE SOUTHEAST, WASHINGTON, DC 20020
(120) 271-0283
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/26/2023
Last updated
10/06/2023
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