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Individual

ANTHONY (MIA) JOEL MIKELIC

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1103 NE ELM ST, PRINEVILLE, OR 97754-1664
(541) 323-5330
(541) 447-1121
Mailing address
934 NE DEL RIO AVE, PRINEVILLE, OR 97754-1364
(541) 362-6979

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
06/13/2018
Last updated
06/13/2018
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