Individual
NICOLE MICKELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13010 NE 20TH ST, SUITE 100, BELLEVUE, WA 98005-2034
(425) 644-6328
Mailing address
13010 NE 20TH ST, SUITE 100, BELLEVUE, WA 98005-2034
(425) 644-6328
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
CG60544493
WA
Other
Enumeration date
06/16/2015
Last updated
06/16/2015
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