Individual
AMY JO MICKLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
217 BROAD ST, PORT ALLEGANY, PA 16743-1209
(814) 642-2755
Mailing address
217 BROAD ST, PORT ALLEGANY, PA 16743-1209
(814) 642-2755
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PC007224
PA
Other
Enumeration date
11/17/2013
Last updated
11/17/2013
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