Individual
ZACHARY MICKELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
185 HIGHWAY 965 NE STE 6, NORTH LIBERTY, IA 52317-6702
(319) 325-6044
Mailing address
325 N GEORGE ST, NORTH LIBERTY, IA 52317-9671
(319) 936-6161
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
124608
IA
Other
Enumeration date
06/28/2024
Last updated
06/28/2024
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