Individual
MRS. MARY LOUISE MIKOLAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR L
Contact information
Practice address
299 EDWARDS ST, YOUNGSTOWN, OH 44502
(330) 743-1168
(330) 743-1616
Mailing address
7100 STEEPLECHASE DRIVE, CANFIELD, OH 44406
(330) 533-1805
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT001299
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0078348
—
OH
Enumeration date
07/12/2006
Last updated
07/08/2007
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