Individual
DEBRA MIKKELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA,CCC-SLP
Contact information
Practice address
3501 NEW LAWRENCE RD, LEAVENWORTH, KS 66048-5223
(913) 246-1078
Mailing address
3501 NEW LAWRENCE RD, LEAVENWORTH, KS 66048-5223
(913) 684-1530
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1386
KS
Other
Enumeration date
03/22/2019
Last updated
11/27/2023
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