Individual
DENISE MICKLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1842 RYDERWOOD CT, HYATTSVILLE, MD 20785-3976
(240) 758-9061
Mailing address
1842 RYDERWOOD CT, HYATTSVILLE, MD 20785-3976
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
01/30/2017
Last updated
01/30/2017
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