Individual
ABBY ROSE MIKITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLBSW, QIDP
Contact information
Practice address
6654 E FAWN AVE, WHITE CLOUD, MI 49349-9326
(616) 414-1068
(616) 591-5723
Mailing address
PO BOX 141004, GRAND RAPIDS, MI 49514-1004
(616) 414-1068
(616) 591-5723
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6802090070
MI
Other
Enumeration date
05/01/2019
Last updated
09/30/2019
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