Individual
MRS. MICKAELA O'SULLIVAN O'NEILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8608 N 59TH AVE, GLENDALE, AZ 85302-5404
(623) 979-2565
Mailing address
8608 N 59TH AVE, GLENDALE, AZ 85302-5404
(732) 796-8617
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/28/2018
Last updated
04/01/2024
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