Organization
MICHELE MARIE MIXON, LCSW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELE MIXON LCSW (OWNER)
(225) 266-8122
Entity
Organization
Contact information
Practice address
2244 11TH ST, MANDEVILLE, LA 70471-1824
(225) 266-8122
Mailing address
2244 11TH ST, MANDEVILLE, LA 70471-1824
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8769
LA
Other
Enumeration date
01/18/2015
Last updated
01/09/2017
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