Individual
JEFF L MICKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
T-LMFT
Contact information
Practice address
212 W DALE ST, WATERLOO, IA 50703-1954
(319) 235-3550
Mailing address
3616 PANTHER LN, CEDAR FALLS, IA 50613-4919
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
120243
IA
Other
Enumeration date
10/06/2023
Last updated
10/06/2023
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