Individual
PAMELA S MICKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
623 W WARWICK DR STE 2, ALMA, MI 48801-1177
(989) 285-1490
Mailing address
623 W WARWICK DR STE 2, ALMA, MI 48801-1177
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
M200676778346
—
MI
Enumeration date
06/26/2020
Last updated
06/26/2020
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