Individual
MRS. TERI RENEE MICKEVICIUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A. CCC-SLP
Contact information
Practice address
7941 STONEHEDGE VALLEY DR, GREGORY, MI 48137-9752
(734) 649-9261
Mailing address
7941 STONEHEDGE VALLEY DR, GREGORY, MI 48137-9752
(734) 649-9261
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101001364
MI
Other
Enumeration date
07/13/2021
Last updated
07/13/2021
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