Individual
ANDREW MICKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3700 MIDWAY DR, BAKER CITY, OR 97814-1456
(541) 523-8320
Mailing address
3700 MIDWAY DR, BAKER CITY, OR 97814-1456
(541) 523-8320
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15-06-10
OR
Other
Enumeration date
02/02/2016
Last updated
02/02/2016
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