Individual
STACY ANN MICELI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4125 N 124TH ST STE AANDB, BROOKFIELD, WI 53005-1837
(920) 857-9041
(920) 857-3366
Mailing address
10554 W CORTEZ CIR APT 1, FRANKLIN, WI 53132-1517
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-25-80340
WI
106S00000X
Behavior Technician
—
—
Other
Enumeration date
01/20/2021
Last updated
07/25/2025
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