Individual
KATHLEEN DENISE MIKKELSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
9560 LINTON HALL RD, BRISTOW, VA 20136-1218
(703) 989-3016
(703) 972-2240
Mailing address
10060 NAUGHTON CT, BRISTOW, VA 20136-3068
(703) 989-3016
(703) 972-2240
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701006940
VA
Other
Enumeration date
01/30/2017
Last updated
05/07/2019
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