Individual
HEATHER M. MIKELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.T.
Contact information
Practice address
1470 E 1200 NORTH RD, MILFORD, IL 60953-6256
(815) 683-2107
Mailing address
1470 E 1200 NORTH RD, MILFORD, IL 60953-6256
(815) 683-2107
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
10/02/2008
Last updated
10/02/2008
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