Individual
BAYLEN MIKKELSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2104 12TH ST, HARLAN, IA 51537-2023
(712) 755-5174
Mailing address
1014 MOCKINGBIRD DR, CARROLL, IA 51401-1822
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
IA
Other
Enumeration date
01/11/2017
Last updated
01/11/2017
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