Individual
DR. CAROLYN T MCMICKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
104 NEWPORT LN, NORTH WALES, PA 19454-1458
(215) 699-6356
Mailing address
104 NEWPORT LN, NORTH WALES, PA 19454-1458
(215) 699-6356
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
—
—
103TC0700X
Clinical Psychologist
Primary
PS016116
PA
Other
Enumeration date
07/14/2009
Last updated
07/14/2009
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