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Individual

MR. LEWIS MICKLEY III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
7517 CAMERON RD, AUSTIN, TX 78752-2057
(844) 206-9063
Mailing address
7517 CAMERON RD, AUSTIN, TX 78752-2057

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13567
TX

Other

Enumeration date
09/21/2016
Last updated
09/21/2016
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