Individual
MR. BRADLEY LOREN MIKON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LLMSW
Contact information
Practice address
44899 CENTRE CT, SIOTE 102, CLINTON TWP, MI 48038-5510
(586) 792-1654
(586) 792-1656
Mailing address
44899 CENTRE CT, SIOTE 102, CLINTON TWP, MI 48038-5510
(586) 792-1654
(586) 792-1656
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801090750
MI
Other
Enumeration date
05/26/2010
Last updated
05/26/2010
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