Individual
BRENDA JOYCE MICELI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
410 VALLEY ST, DAYTON, OH 45404-1843
(937) 641-3401
(937) 641-3066
Mailing address
PO BOX 933421, CLEVELAND, OH 44193-0039
(937) 641-3000
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
5477
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2104083
—
OH
Enumeration date
10/03/2006
Last updated
10/15/2023
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