Individual
CHERYL DIANE MIKESKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
2813 APPLE CREEK CIR, BRYAN, TX 77802-2904
(979) 774-5011
(979) 774-5011
Mailing address
2402 BROADMOOR DR STE A102, BRYAN, TX 77802-2800
(979) 774-5011
(979) 774-5011
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
12244
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1426462-01
—
TX
Enumeration date
08/01/2008
Last updated
08/01/2008
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