Individual
MIKAYLA REESE PERCELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1351 NEWTOWN PIKE, LEXINGTON, KY 40511-1275
(859) 253-1686
Mailing address
1307 E ELM ST, ATHENS, AL 35611-5318
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
258086
KY
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790731081
—
KY
Enumeration date
02/25/2020
Last updated
03/06/2023
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