Individual
KATELYN ANN MICKELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2400 32ND AVE S, FARGO, ND 58103-5800
(701) 234-2000
(701) 234-3120
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-6585
(605) 328-6512
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
609P
ND
103T00000X
Psychologist
Primary
622
ND
103TC0700X
Clinical Psychologist
LP6215
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/29/2015
Last updated
05/22/2025
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