Individual
MICHAEL MICLIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
231 CROSSWICKS RD STE 1, BORDENTOWN, NJ 08505-2602
(609) 379-6135
Mailing address
231 CROSSWICKS RD STE 1, BORDENTOWN, NJ 08505-2602
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/23/2021
Last updated
09/23/2021
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