Individual
ASHLEY MARIE MICKELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
889 GORDON RD, WHITEWRIGHT, TX 75491-7102
(903) 926-8456
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
(318) 675-6262
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
L-302053
—
235Z00000X
Speech-Language Pathologist
Primary
6440
LA
Other
Enumeration date
12/03/2009
Last updated
07/25/2023
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